For acute myeloid leukemia (AML) with nucleophosmin 1 mutation (NPM1m), multiparameter flow cytometry (FCM) and real-time quantitative polymerase chain reaction (RQ-PCR) are used to monitor minimal residual disease (MRD). However, the results of the two methods are sometimes inconsistent. This study was designed to analyze how to address the discordant results of FCM and RQ-PCR in AML patients undergoing chemotherapy, especially when positive FCM (FCM+) and negative NPM1m (NPM1m-) results are detected in the same sample. Our study included 93 AML patients with NPM1m positive (NPM1m+) who received chemotherapy but did not undergo hematopoietic stem cell transplantation. We monitored NPM1m and leukemia-associated immunophenotypes (LAIPs) by RQ-PCR and FCM, respectively, to assess MRD after each chemotherapy course. After each course of chemotherapy, all patients were classified into four groups based on the results of FCM and RQ-PCR: both negative (group 1, FCM-NPM1m-), single positive (group 2, FCM-NPM1m+; group 3, FCM+NPM1m-), or both positive (group 4, FCM+NPM1m+). The results showed that there was not a significant difference in the 2-year cumulative incidence of relapse (CIR) after each course of chemotherapy between group 2 and group 3. Furthermore, patients in groups 2 and 3 had a lower 2-year CIR than those in group 4 and a significantly higher 2-year CIR than those in group 1 after the first two courses. The patients in group 4 had a significantly higher 2-year CIR than those in group 1 after the first two courses. These results suggested that in the MRD monitoring process of AML patients, when the results of FCM and RQ-PCR are inconsistent (especially when FCM is positive and NPM1m is negative), these single-positive results still have predictive significance for relapse.

中文翻译：

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当实时定量PCR和流式细胞仪检测到NPM1突变的急性髓细胞性白血病中检测到的结果不一致时，最小残留病的预测价值。

对于具有核磷蛋白1突变（NPM1m）的急性髓细胞白血病（AML），多参数流式细胞术（FCM）和实时定量聚合酶链反应（RQ-PCR）用于监测最小残留病（MRD）。但是，两种方法的结果有时不一致。本研究旨在分析如何解决正在接受化疗的AML患者中FCM和RQ-PCR不一致的结果，特别是当在同一样本中检测到阳性FCM（FCM +）和阴性NPM1m（NPM1m-）时。我们的研究包括93例NPM1m阳性（NPM1m +）的AML患者，他们接受了化疗但未进行造血干细胞移植。我们分别通过RQ-PCR和FCM监测了NPM1m和白血病相关的免疫表型（LAIP），以评估每个化疗疗程后的MRD。每次化疗后，根据FCM和RQ-PCR的结果将所有患者分为四组：阴性（第1组，FCM-NPM1m-），单阳性（第2组，FCM-NPM1m +；第3组，FCM + NPM1m-），或均为阳性（第4组，FCM + NPM1m +）。结果显示，第2组和第3组在每个化疗疗程后的2年累积复发率（CIR）之间没有显着差异。此外，第2和第3组患者的2年CIR低于前两门课程后，第4组的2年CIR明显高于第1组。前两个疗程后，第4组的患者的2年CIR明显高于第1组。这些结果表明，在AML患者的MRD监测过程中，