The Factors Affecting Relapse in Pediatric B-cell Acute Lymphoblastic Leukemia Patients without Prognostic Fusion Genes Following Up for 10 years.
10.19746/j.cnki.issn.1009-2137.2022.01.003
- Author:
Meng-Ying JIANG
1
;
Wei GAO
1
;
Jing GAO
1
;
Jing LING
1
;
Jian PAN
1
;
Pei-Fang XIAO
1
;
Jun LU
1
;
Hai-Long HE
1
;
Yi WANG
1
;
Jie LI
1
;
Jian-Qin LI
1
;
Yi-Huan CHAI
1
;
Yi-Na SUN
2
;
Shao-Yan HU
3
Author Information
1. Department of Hematology, Children's Hospital of Soochow University , Suzhou 215025, Jiangsu Province, China.
2. Department of Hematology, Children's Hospital of Soochow University , Suzhou 215025, Jiangsu Province, China,E-mail: syn1117@126.com.
3. Department of Hematology, Children's Hospital of Soochow University , Suzhou 215025, Jiangsu Province, China,E-mail: hushaoyan@suda.edu.cn.
- Publication Type:Journal Article
- Keywords:
acute lymphoblastic leukemia;
children;
prognosis;
prognostic fusion gene;
relapse
- MeSH:
Antineoplastic Combined Chemotherapy Protocols;
Child;
Child, Preschool;
Disease-Free Survival;
Female;
Humans;
Male;
Neoplasm, Residual;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics*;
Prognosis;
Recurrence;
Retrospective Studies
- From:
Journal of Experimental Hematology
2022;30(1):12-17
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the efficacy of children with B-cell acute lymphoblastic leukemia (B-ALL) without prognostic fusion genes treated by CCLG-ALL 2008, and investigate the related factors affecting the recurrence of the patients.
METHODS:B-ALL patients without prognostic fusion genes treated by the protocol of CCLG-ALL 2008 in our hospital from March 2008 to December 2012 were retrospectively analyzed. Follow-up time was ended in August 31, 2019. The median follow-up time was 92 months (range 0-136 months). Kaplan-Meier was used to detect the RFS, and COX multivariate regression analysis was employed to identify the independent factors affecting the recurrence of the patients.
RESULTS:There were 140 males and 99 females enrolled in this study. The ratio of male to female was 1.41∶1. The median age was 4.4 years old and the median number of WBC at initial stage was 4.98×109/L. There were 77 cases relapsed during the observation while 162 without relapsed, 16 cases lost to follow-up and 72 cases died. The recurrence and mortality rate was 32.22% and 30.1%, respectively, in which 45 cases died of recurrence (62.5% of the total deaths). Univariate analysis showed that the age≥6 years old, WBC >100×109/L, the bone marrow blasts on day 15≥25%, the bone marrow minimal residual disease (MRD) at week 12 >10-4, and the higher risk were the main factors affecting the recurrence of the patients (P<0.05). Multivariate COX regression analysis showed that age≥6 years old, WBC >100×109/L, bone marrow MRD >10-4 at the 12th week were the independent risk factors affecting recurrence of the patients.
CONCLUSION:Age, initial WBC, and bone marrow MRD at the 12th week were correlated with recurrence in children with B-ALL without prognostic fusion genes, which can be used as prognostic indices of recurrence risk in clinical.
