Outcome of 126 adolescent and adult T-cell acute leukemia/lymphoma patients and the prognostic significance of early T-cell precursor leukemia subtype
10.3760/cma.j.issn.0253-2727.2019.07.005
- VernacularTitle: 青少年和成人急性T淋巴细胞白血病/淋巴瘤126例临床分析及急性早期前体T淋巴细胞白血病/淋巴瘤分型预后意义的初步探讨
- Author:
Hongyan LIAO
1
;
Zhuoyi SUN
2
;
Yanxi WANG
1
;
Yongmei JIN
1
;
Huanling ZHU
3
;
Nenggang JIANG
1
Author Information
1. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
2. National Center for Clinical Laboratories, Beijing 100730, China
3. Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
- Publication Type:Journal Article
- Keywords:
Leukemia, T-cell;
Leukemia, early T-cell precursor;
Immunophenotype;
Flow cytometry;
Prognosis
- From:
Chinese Journal of Hematology
2019;40(7):561-567
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical characteristics of T-cell acute leukemia/lymphoma (T-ALL) and explore the prognosis significance of early T-cell precursor leukemia/lymphoma.
Methods:A cohort of 126 patients diagnosed with T-ALL from 2008 to 2014 in West China Hospital, Sichuan University were enrolled in this study. They were further categorized by immunophenotype according to the expression of T-cell lineage markers CD1a, CD8, CD5 and one or more stem cell or myeloid markers. The laboratory indicators and prognosis factors were also statistically analyzed.
Results:Of all patients, the ratio of male to female was 2.5∶1, with the median age of 25 years old (range 14 to 77) . The percentage of ETP-ALL was up to 47.6%. T-ALL patients showed higher ratio in first clinical remission rate (CR1) than T-LBL ones (64.4% vs 30.8%, P=0.032) . Group with WBC count higher than 50×109/L at presentation showed higher ration of achieving CR1 than those lower than 50×109/L (78.4% vs 50.9%, P=0.010) . In comparison with the non-ETP-ALL, ETP-ALL patients had older age of onset (P<0.001) , lower WBC count (P<0.001) , lower risk of CNS involvement (10.0% vs 30.2%, P=0.009) and slightly inferior overall survival (P=0.073) . T-cell lineage markers CD1a-, CD8- and CD4- positive patients had higher CR1 than their corresponding negative ones (P=0.002, P=0.000, P=0.001) , while CD33- and CD56- positive patients had lower ratio of achieving CR1 than their negative ones, respectively (P=0.035, P=0.035) .
Conclusion:Flow cytometry and associated markers for immunophenotyping was of significance in the diagnosis and prognosis monitoring of T-ALL/LBL. The percentage of ETP-ALL/LBL subtype was high in Chinese adolescent and adult T-ALL patients. ETP-ALL/LBL was a high risk subtype, which needs more precise standard for diagnosis and advanced therapies for better outcome.
