Impact of pre-transplantation minimal residual disease (MRD) on the outcome of Allogeneic hematopoietic stem cell transplantation for acute leukemia

Figures & data

Table 1. Clinical characteristics of 114 patients before transplantation.

Clinical features	MRD+ (N = 32)	MRD− (N = 82)	p-value
Gender			0.105
Male	11 (34.4%)	42 (51.2%)
Female	21 (65.6%)	40 (48.8%)
Age	40 (13–64)	38 (11–65)	0.365
Disease			0.08
ALL	8 (25%)	35 (42.7%)
AML	24 (75%)	47 (57.3%)
Remission state			0.192
CR1	25 (78.1%)	72 (87.8%)
CR≥2	7 (21.9%)	10 (12.2%)
Transplant type			0.664
Haplo-HSCT	19 (59.4%)	45 (54.9%)
MSD-HSCT	13 (40.6%)	37 (45.1%)
Number of infused cells
CD34(10^6/kg)	5.74 (2.4–14.1)	5.03 (1.0–44.5)	0.082
MNC(10^8/kg)	10.2 (3.7–20.0)	8.2 (3.4–23.25)	0.072

Note: CR, complete remission; Haplo-HSCT, haploidentical hematopoietic stem cell transplantation; MSD-HSCT, matched sibling donor hematopoietic stem cell transplantation; MNC, mononuclear cell.

Table 2. Comparison of observation indexes after transplantation.

	MRD+ (N = 32)	MRD− (N = 82)	p-value
Cell engraftment time
Neutrophils (day)	12 (9–22)	14.5 (8–25)	0.672
Platelets (day)	13 (10–32)	15 (5–35)	0.708
GVHD	26	73	0.270
aGVHD  I-II aGVHD  III-IV aGVHD	22 (68.8%) 18(56.3%) 4(12.5%)	42 (51.2%) 30(36.6%) 12(14.6%)	0.090
cGVHD	4 (12.5%)	31 (37.8%)	0.008

Note: GVHD, graft-versus-host disease; aGVHD, acute graft-versus-host disease; cGVHD, chronic graft-versus-host disease.

Figure 1. Kaplan–Meier curves of (A) overall survival (OS), (B) progression-free survival (PFS), (C) cumulative incidence of relapse between the MRD+ group and MRD− group.

Figure 2. Kaplan–Meier curves of (A) non-relapse mortality (NRM), (B) GVHD/Relapse-Free survival (GRFS) between the MRD+ group and MRD− group.

Table 3. Analysis of risk factors for OS.

Risk factors	Univariate analysis	Multivariate analysis
	p-value HR	p-value HR
Gender	0.322 0.751 (0.426–1.325)
Age	0.144 1.017 (0.994–1.041)
Pre-MRD	0.004 2.335 (1.312–4.156)	0.032 1.921 (1.056–3.495)
Remission sate	0.44 1.332 (0.643–2.760)
Disease (AML or ALL)	0.164 0.642 (0.344–1.198)
Donor	0.015 2.138 (1.157–3.951)	0.006 2.391 (1.287–4.442)
The number of CD34+	0.298 0.960 (0.888–1.037)
The number of TNC	0.502 0.977 (0.914–1.045)
Relapse	0.001 2.643 (1.465–4.771)	0.004 2.491 (1.344–4.617)

Note: AML, acute myeloid leukemia; ALL, acute lymphoblastic leukemia; MNC, mononuclear cell.