Refining Risk Stratification for B-cell Precursor Adult Acute Lymphoblastic Leukemia Treated With a Pediatric-inspired Regimen by Combining IKZF1 Deletion and Minimal Residual Disease

作者：Shiyu Deng, Jiawang Ou, Junjie Chen, Zicong Huang, Zihong Cai, Xiuli Xu, Bingqing Tang, Chenhao Ding, Jia Li, Ren Lin, Zhixiang Wang, Ting Zhang, Qifa Liu, Hongsheng Zhou · 发表于：Transplantation and Cellular Therapy · 年份：2025 · DOI：10.1016/j.jtct.2025.01.003 · 被引用次数：8 · 研究领域：Acute Lymphoblastic Leukemia research、Acute Myeloid Leukemia Research、Lymphoma Diagnosis and Treatment

INTRODUCTION: Minimal residual disease (MRD) is the most important prognostic factor for B-cell acute lymphoblastic leukemia (B-ALL) however nearly 20-30% of patients relapsed even when they achieved negative MRD, how to identify these patients is less addressed. In this study, we aimed to reassess the prognostic significance of MRD and IKZF1 in adult B-ALL patients receiving pediatric chemotherapy regimens. METHODOLOGY: A total of 202 newly diagnosed adult patients with B-ALL treated at Nanfang Hospital between January 2016 and September 2020 were enrolled in the population-based protocol of the PDT-ALL-2016 trial (NCT03564470), a GRAALL-backbone, peg-aspargase-intensified, antimetabolite-based pediatric-inspired regimen therapy. The validation dataset COG-P9906, which includes complete gene expression profiles and clinical data for 190 samples, is accessible via the NCBI Gene Expression Omnibus (GEO) at the following link: (https://www.ncbi.nlm.nih.gov/geo/), under the accession code GSE11877. MAIN FINDINGS: B-ALL patients were redefined as standard (MRD-negative and IKZF1wild-type), intermediate (MRD-positive or IKZF1 deletion), and high-risk (MRD-positive and IKZF1 deletion) groups by combining IKZF1 deletion status and MRD. In the PDT-ALL-2016 cohort, patients in the high- and intermediate-risk groups who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) exhibited significantly improved 5-year overall survival (OS), event-free survival (EFS), and l...