Abstract
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.