Clinical Features and Prognosis of Acute T-cell Lymphoblastic Leukemia in Children——Multi-Center Data Analysis in Fujian
10.19746/j.cnki.issn1009-2137.2024.01.002
- VernacularTitle:儿童急性T淋巴细胞白血病的临床特征及预后
- Author:
Chun-Ping WU
1
;
Yong-Zhi ZHENG
;
Jian LI
;
Hong WEN
;
Kai-Zhi WENG
;
Shu-Quan ZHUANG
;
Xing-Guo WU
;
Xue-Ling HUA
;
Hao ZHENG
;
Zai-Sheng CHEN
;
Shao-Hua LE
Author Information
1. 福建医科大学附属协和医院小儿血液科,福建省血液病研究所,福建省血液病学重点实验室,福建福州 350001
- Keywords:
acute T-cell lymphoblastic leukemia;
child;
adverse event;
efficacy
- From:
Journal of Experimental Hematology
2024;32(1):6-13
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of acute T-cell lymphoblastic leukemia(T-ALL)in children and explore the prognostic risk factors.Methods:The clinical data of 127 newly diagnosed children with T-ALL admitted to five hospitals in Fujian province from April 2011 to December 2020 were retrospectively analyzed,and compared with children with newly diagnosed acute precursor B-cell lymphoblastic leukemia(B-ALL)in the same period.Kaplan-Meier analysis was used to evaluate the overall survival(OS)and event-free survival(EFS),and COX proportional hazard regression model was used to evaluate the prognostic factors.Among 116 children with T-ALL who received standard treatment,78 cases received the Chinese Childhood Leukemia Collaborative Group(CCLG)-ALL 2008 protocol(CCLG-ALL 2008 group),and 38 cases received the China Childhood Cancer Collaborative Group(CCCG)-ALL 2015 protocol(CCCG-ALL 2015 group).The efficacy and serious adverse event(SAE)incidence of the two groups were compared.Results:Proportion of male,age ≥ 10 years old,white blood cell count(WBC)≥ 50 × 109/L,central nervous system leukemia,minimal residual disease(MRD)≥ 1％during induction therapy,and MRD ≥ 0.01％at the end of induction in T-ALL children were significantly higher than those in B-ALL children(P＜0.05).The expected 10-year EFS and OS of T-ALL were 59.7％and 66.0％,respectively,which were significantly lower than those of B-ALL(P＜0.001).COX analysis showed that WBC ≥ 100 x 109/L at initial diagnosis and failure to achieve complete remission(CR)after induction were independent risk factors for poor prognosis.Compared with CCLG-ALL 2008 group,CCCG-ALL 2015 group had lower incidence of infection-related SAE(15.8％vs 34.6％,P=0.042),but higher EFS and OS(73.9％vs 57.2％,PEFS=0.090;86.5％vs 62.3％,PoS=0.023).Conclusions:The prognosis of children with T-ALL is worse than children with B-ALL.WBC ≥ 100 × 109/L at initial diagnosis and non-CR after induction(especially mediastinal mass has not disappeared)are the risk factors for poor prognosis.CCCG-ALL 2015 regimen may reduce infection-related SAE and improve efficacy.
