Clinical features and prognosis of high hyperdiploid childhood acute lymphoblastic leukemia: a multicenter retrospective analysis in Fujian Province, China.
10.7499/j.issn.1008-8830.2208126
- Author:
Chun-Xia CAI
1
;
Yong-Zhi ZHENG
1
;
Jian LI
1
;
Hong WEN
;
Kai-Zhi WENG
;
Shu-Quan ZHUANG
;
Xing-Guo WU
;
Shao-Hua LE
1
Author Information
1. Department of Pediatric Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory, Fuzhou 350001, China.
- Publication Type:Journal Article
- Keywords:
Acute lymphoblastic leukemia;
Child;
High hyperdiploid;
Prognosis
- MeSH:
Child;
Humans;
Retrospective Studies;
Trisomy;
Prognosis;
Treatment Outcome;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis*;
Neoplasm, Residual;
Disease-Free Survival
- From:
Chinese Journal of Contemporary Pediatrics
2023;25(1):38-45
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To study the clinical features and prognosis of high hyperdiploid (HHD) childhood acute lymphoblastic leukemia (ALL).
METHODS:A retrospective analysis was performed on the medical data of 1 414 children who were newly diagnosed with ALL and were admitted to five hospitals in Fujian Province of China from April 2011 to December 2020. According to karyotype, they were divided into two groups: HHD (n=172) and non-HHD (n=1 242). The clinical features and treatment outcome were compared between the two groups, and the factors influencing the prognosis were further explored.
RESULTS:Among the 1 414 children with ALL, 172 (12.16%) had HHD. Compared with the non-HHD group, the HHD group had significantly lower proportions of children with risk factors for poor prognosis at diagnosis (age of onset ≥10 years or <1 year, white blood cell count ≥50×109/L, and T-cell phenotype) or positive fusion genes (TEL-AML1, BCR-ABL1, E2A-PBX1, and MLL gene rearrangement) (P<0.05). The HHD group had a significantly higher proportion of children with minimal residual disease (MRD) <0.01% at the end of induction chemotherapy (P<0.05). The 10-year event-free survival (EFS) rate and overall survival (OS) rate in the HHD group were significantly higher than those in the non-HHD group (P<0.05). The univariate analysis showed that the number of chromosomes of 58-66, trisomy of chromosome 10, trisomy of chromosome 17, bone marrow MRD <1% on day 15 or 19 of induction chemotherapy, and bone marrow MRD <0.01% on day 33 or 46 of induction chemotherapy were associated with a higher EFS rate (P<0.05), and trisomy of chromosome 10 was associated with a higher OS rate (P<0.05). The multivariate Cox analysis showed that trisomy of chromosome 17 was closely associated with a high EFS rate (P<0.05).
CONCLUSIONS:The ALL children with HHD have few risk factors for poor prognosis at diagnosis and often have good prognosis. The number of chromosomes and trisomy of specific chromosomes are associated with prognosis in these children.
