Hafsa Binte Younus Jannat Irfan Maria Ashraf


Introduction: Most children diagnosed with acute lymphoblastic leukemia are cured and are not at risk of relapse. However, 20% of children are at a high risk of experiencing relapse later on in their lives. In order to detect risk and obtain prognostic information, the quantification of minimal residual disease (MRD) can be utilized. Detection of MRD can lead to efficient identification of relapse risk. However, there is limited understanding of the association between MRD and long-term outcomes after treatment in children. Therefore, this systematic review will examine existing literature to determine the strength of association between MRD negativity and relapse risk in children and its importance in the prediction of relapse. 

Methods: A systematic review of 5 articles centered around ALL in children was analyzed to examine the strength of association between MRD negativity and clinical outcomes of event-free survival (EFS) and overall survival (OS) following the PRISMA guideline. The literature search was done through databases such as NCBI, PubMed, and other childhood oncology databases. The inclusion criteria included peer-reviewed clinical studies that focus on ALL relapse risk and MRD detection. Additionally, reviews, abstracts, and studies with inadequate sample sizes or correlations were excluded. Data were extracted and organized based on criteria of MRD negativity, MRD detection type, and relapse risk level. The data collected from all studies were analyzed through a meta-analysis. The five publications discussed in this article were a total of 11,265 participants.

Results: Results: The results portion of your abstract should concisely describe a summary of the main findings. A positive correlation was determined between EFS and OS hazard ratios and MRD detection.

Discussion: The analysis of the five publications demonstrated that MRD is an important marker and a strong predictor of relapse in children who are diagnosed with ALL. 

Conclusion: MRD detection can be proposed as a method of predicting a high risk of relapse in children with ALL. In essence, this literature review has the potential to identify the clinical and therapeutic significance of MRD testing which can be utilized to predict and prevent relapse of ALL in children.

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