minimal residual disease in acute lymphoblastic leukaemia and its relationship with other prognostic factors

Background: minimal residual disease (mrd) assessment is crucial for directing treatment decisions in acute lymphoblastic leukemia (all). in low- and middle-income countries, limited resources can present challenges to implementing mrd-guided therapy intensification for all. the study attempted to assess the relationship between mrd and other prognostic factors in all, focusing on treatment outcomes and disease progression.materials and methods: a retrospective observational study was conducted at ramaiah medical college and hospital in bengaluru, examining patient data from january 2021 to december 2021. mrd status was determined post-induction using flow cytometry. patients were classified into various groups based on factors such as type of all (b-cell or t-cell), nci risk status (standard or high), cytogenetic risk (favorable, poor, or intermediate), cns status, prednisone response, and mrd levels at the end of induction.results: out of 72 patients, 25% were mrd-positive, with a male: female ratio of 2.13:1. b-all was diagnosed in 49 patients and t-all in 23, with 75% categorized as high-risk by nci criteria. cytogenetic analysis revealed a diverse profile (23.61% pr, 48.61% ir, 27.78% fr), and 58.33% exhibited a good prednisone response (gpr). at the end of the induction phase, 25% tested positive for mrd, with b-all showing a lower mrd rate at 15.2%. age and nci risk status significantly influenced mrd outcomes, with 75% of participants classified as high-risk.conclusion: this study demonstrates a significant association between mrd positivity and factors such as age, nci risk status, and b-all diagnosis, underscoring the complex interaction of these variables in predicting treatment outcomes for all patients.