Clinical features and outcome of pediatric acute lymphoblastic leukemia with low peripheral blood blast cell count at diagnosis

被引:14
作者
Dai, Qingkai [1 ,2 ]
Zhang, Ge [1 ,2 ]
Yang, Hui [1 ,2 ]
Wang, Yuefang [1 ,2 ]
Ye, Lei [1 ,2 ]
Peng, Luyun [1 ,2 ]
Shi, Rui [1 ,2 ]
Guo, Siqi [1 ,2 ]
He, Jiajing [1 ,2 ]
Jiang, Yongmei [1 ,2 ]
机构
[1] Sichuan Univ, West China Univ Hosp 2, Dept Lab Med, 20,Sect 3, Chengdu 610041, Sichuan, Peoples R China
[2] Sichuan Univ, Minist Educ, Key Lab Birth Defects & Related Dis Women & Child, Chengdu, Peoples R China
关键词
acute lymphoblastic leukemia; children; peripheral blood blast cell; prognostic factor; MINIMAL RESIDUAL DISEASE; CHILDHOOD T-CELL; DETERMINES RELAPSE RISK; PRECURSOR B-CELL; FLOW-CYTOMETRY; PROGNOSTIC-SIGNIFICANCE; ANTIGEN-EXPRESSION; CHILDREN; CD45; CLASSIFICATION;
D O I
10.1097/MD.0000000000024518
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Peripheral blood (PB) blast cell count on day 8 of prednisone therapy has been considered one of the strongest predictors of outcome in children with acute lymphoblastic leukemia (ALL). However, little is known about the clinical features and prognostic impact of PB blast cell count at diagnosis in these patients. The aim of this study was to evaluate the relationship between initial PB blast cell count and clinical prognosis of pediatric ALL. The study comprised 367 patients with ALL, aged 0 to 14 years, enrolled and treated using the Chinese Children's Leukemia Group-ALL 2008 protocol between 2011 and 2015. The majority (91.6%) of patients were B-cell precursor ALL (BCP ALL), and 8.4% were T-cell ALL (T-ALL). Patients with BCP ALL in the low PB blast cell count group (<1 x 10(9)/L) had significantly superior survival rates to those in the high count group (>= 30 x 10(9)/L). In T-ALL, the low count group showed significantly inferior survival rates compared to both the intermediate count group (1-29.9 x 10(9)/L) and high count group. Multivariate analysis revealed that the initial white blood cell count and minimal residual disease at the end of induction therapy were independently predictive of BCP ALL outcome, while risk stratification was shown to be an independent prognostic factor for T-ALL outcome. These results indicated that low blast cell count in PB at diagnosis was associated with different clinical outcomes in patients with BCP ALL and T-ALL, although it was not an independent outcome predictor by multivariate analysis.
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页数:9
相关论文
共 55 条
[31]   Mutation of the receptor tyrosine phosphatase PTPRC (CD45) in T-cell acute lymphoblastic leukemia [J].
Porcu, Michael ;
Kleppe, Maria ;
Gianfelici, Valentina ;
Geerdens, Ellen ;
De Keersmaecker, Kim ;
Tartaglia, Marco ;
Foa, Robin ;
Soulier, Jean ;
Cauwelier, Barbara ;
Uyttebroeck, Anne ;
Macintyre, Elizabeth ;
Vandenberghe, Peter ;
Asnafi, Vahid ;
Cools, Jan .
BLOOD, 2012, 119 (19) :4476-4479
[32]  
PUI CH, 1993, BLOOD, V82, P343
[33]   CHARACTERIZATION OF CHILDHOOD ACUTE-LEUKEMIA WITH MULTIPLE MYELOID AND LYMPHOID MARKERS AT DIAGNOSIS AND AT RELAPSE [J].
PUI, CH ;
RAIMONDI, SC ;
HEAD, DR ;
SCHELL, MJ ;
RIVERA, GK ;
MIRRO, J ;
CRIST, WM ;
BEHM, FG .
BLOOD, 1991, 78 (05) :1327-1337
[34]   Global efforts toward the cure of childhood acute lymphoblastic leukaemia [J].
Pui, Ching-Hon ;
Yang, Jun J. ;
Bhakta, Nickhill ;
Rodriguez-Galindo, Carlos .
LANCET CHILD & ADOLESCENT HEALTH, 2018, 2 (06) :440-454
[35]   Clinical utility of sequential minimal residual disease measurements in the context of risk-based therapy in childhood acute lymphoblastic leukaemia: a prospective study [J].
Pui, Ching-Hon ;
Pei, Deqing ;
Coustan-Smith, Elaine ;
Jeha, Sima ;
Cheng, Cheng ;
Bowman, W. Paul ;
Sandlund, John T. ;
Ribeiro, Raul C. ;
Rubnitz, Jeffrey E. ;
Inaba, Hiroto ;
Bhojwani, Deepa ;
Gruber, Tanja A. ;
Leung, Wing H. ;
Downing, James R. ;
Evans, William E. ;
Relling, Mary V. ;
Campana, Dario .
LANCET ONCOLOGY, 2015, 16 (04) :465-474
[36]   Significance of commonly used prognostic factors differs for children with T cell acute lymphocytic leukemia (ALL), as compared to those with B-precursor ALL. A Pediatric Oncology Group (POG) study [J].
Pullen, J ;
Shuster, JJ ;
Link, M ;
Borowitz, M ;
Amylon, M ;
Carroll, AJ ;
Land, V ;
Look, AT ;
McIntyre, B ;
Camitta, B .
LEUKEMIA, 1999, 13 (11) :1696-1707
[37]   Monitoring treatment response of childhood precursor B-cell acute lymphoblastic leukemia in the AIEOP-BFM-ALL 2000 protocol with multiparameter flow cytometry: predictive impact of early blast reduction on the remission status after induction [J].
Ratei, R. ;
Basso, G. ;
Dworzak, M. ;
Gaipa, G. ;
Veltroni, M. ;
Rhein, P. ;
Biondi, A. ;
Schrappe, M. ;
Ludwig, W-D ;
Karawajew, L. .
LEUKEMIA, 2009, 23 (03) :528-534
[38]   CHEMOTHERAPY IN 998 UNSELECTED CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA PATIENTS - RESULTS AND CONCLUSIONS OF THE MULTICENTER TRIAL ALL-BFM-86 [J].
REITER, A ;
SCHRAPPE, M ;
LUDWIG, WD ;
HIDDEMANN, W ;
SAUTER, S ;
HENZE, G ;
ZIMMERMANN, M ;
LAMPERT, F ;
HAVERS, W ;
NIETHAMMER, D ;
ODENWALD, E ;
RITTER, J ;
MANN, G ;
WELTE, K ;
GADNER, H ;
RIEHM, H .
BLOOD, 1994, 84 (09) :3122-3133
[39]  
Riehm H, 1990, Haematol Blood Transfus, V33, P439
[40]   Treatment results in childhood acute lymphoblastic leukemia with a modified ALL-BFM'90 protocol: lack of improvement in high-risk group [J].
Sackmann-Muriel, F ;
Felice, MS ;
Zubizarreta, PA ;
Alfaro, E ;
Gallego, M ;
Rossi, J ;
Cygler, AM .
LEUKEMIA RESEARCH, 1999, 23 (04) :331-340