Plasma-based transcriptomic non-coding signature for predicting relapse in pediatric acute lymphoblastic leukemia

Pediatric Acute Lymphoblastic Leukemia (ALL) is the most common malignant tumor of the hematological system in children, and its relapse after treatment has consistently been a significant factor hindering prognosis. This study aimed to develop a blood-based non-invasive method for predicting relapse in children with ALL. Two cohorts of pediatric ALL patients were analyzed. Through high-throughput profiling, three miRNAs and three circRNAs were identified as potential biological markers, exhibiting a gradient increase in expression from healthy controls to the relapsed group. Logistic regression analysis revealed the superior predictive ability of the combined non-coding RNA panel compared to individual groups. A nomogram incorporating the non-coding RNA panel and other clinical risk features was developed. Combining the non-coding RNA panel with relevant risk features could enhance predictive accuracy. The non-coding RNA panel remained an independent predictor of relapse in the validation cohort, and its combination with clinical features formed a superior risk stratification model. In conclusion, this blood-based non-invasive method holds promise for predicting relapse in pediatric ALL patients at the time of initial diagnosis. The non-coding RNA panel, along with clinical risk features, may significantly impact patient care and outcomes.