ArticleFrontiers in oncology2026
Pre-transplant measurable residual disease by flow cytometry is an independent prognostic factor in pediatric acute myeloid leukemia undergoing allogeneic hematopoietic stem cell transplantation.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical treatment for pediatric acute myeloid leukemia (AML); however, relapse after transplantation remains a major challenge. This study aimed to evaluate the prognostic value of pre-transplant measurable residual disease (MRD) detected by multiparameter flow cytometry (MFC) and high-risk (HR) fusion genes on survival after transplantation. Methods: This single-center retrospective study included 80 newly diagnosed pediatric AML patients who underwent allo-HSCT during their first complete remission between October 2019 and October 2025. All patients were treated according to the C-HUANAN-AML 15 protocol prior to transplantation, with risk stratification and treatment decisions based on European LeukemiaNet criteria and serial MFC-MRD assessments. Cox regression models were employed for statistical analysis. Results: With a median follow-up of 34.5 months, the 3-year disease-free survival (DFS) and overall survival (OS) rates were 85.5% ± 4.2% and 86.8% ± 4.1%, respectively. Univariate analysis identified several risk factors for inferior survival, but multivariate analysis confirmed pre-transplant MFC-MRD positivity as an independent adverse prognostic factor for both 3-year DFS and OS (DFS: HR = 14.304, 95%CI: 1.892-108.155, Conclusion: Pre-transplant MFC-MRD positivity is an independent adverse prognostic marker for survival in pediatric AML patients following allo-HSCT. Patients harboring HR fusion genes such as
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