Non-specific Clones Hamper the Reliability of Immunoglobulin Light Chain Gene Rearrangements in Next-Generation Sequencing-Based Measurable Residual Disease Monitoring in Pediatric B-Cell Acute Lymphoblastic Leukemia: A Single-Center Cohort Study

Background: ) rearrangements are unreliable biomarkers for NGS-based MRD monitoring. Methods: This single-center prospective observational cohort study enrolled 506 pediatric patients newly diagnosed as having B-ALL between 2018 and 2022. NGS was performed on bone marrow samples collected at multiple time points, including the end of induction and consolidation. Results: clones at 12 months in patients in remission from 12.4% to 2.5%. Conclusions: rearrangements for NGS-based MRD monitoring in pediatric B-ALL. Filtering out these clones may enhance accuracy by reducing false positives.