Abstract: Objective　To analyze the clinical data of children with B-cell acute lymphoblastic leukemia (B-ALL) treated under the SCCLG-ALL-2016 protocol, to explore the impact of CD20 expression on the prognosis of children with B-ALL, and to provide a scientific basis for future clinical personalized and precision clinical treatment. Methods A retrospective analysis of the clinical data of 273 newly diagnosed B-ALL children treated by the South China Children's Acute Lymphoblastic Leukemia Treatment Cooperation Group from six centers between October 2016 and June 2023 was conducted. Clinical features, chromosomal karyotypes, fusion genes, clinical risk stratification, early and long-term outcomes were analyzed, and survival analysis was performed by plotting survival curve methods. Results Among the 273 newly diagnosed B-ALL pediatric patients, the CD20-positive expression rate was 26.9%. When compared to CD20-negative individuals, there were statistically significant differences in terms of leukemia gene fusion and mutations (P<0.05). However, no statistically significant differences were observed in initial age, gender, initial white blood cell count, liver-spleen condition, chromosomal karyotype, induction bone marrow leukemia residual on days 15 and 33, and relapse (P>0.05). The CD20-positive group had a total survival rate (OS) of (71.9±10.1)%, lower than the CD20-negative group which was (86.8±4.0)%. The 3-year event-free survival rate (EFS) was (81.2±5.6)%, lower than the CD20-negative group which was (89.5±2.2)%, but the difference between the two groups was not statistically significant (P>0.05). Moreover, there were no statistically significant differences in the total survival rate and 3-year EFS between CD20-positive patients with or without IKZF1 segment deletion (P>0.05). Univariate and multivariate Cox regression analyses related to 3-year EFS and OS indicated that spleen condition and risk stratification were related to 3-year EFS in the univariate analysis; multivariate analysis showed that spleen condition and risk stratification were independent prognostic factors affecting 3-year EFS. Factors related to OS in the univariate analysis were spleen condition, bone marrow on day 15, risk stratification, and relapse, with multivariate analysis indicating that relapse was an independent prognostic factor affecting OS. Conclusions In pediatric B-ALL, CD20 expression is related to the expression of fusion genes, yet it is not a prognostic factor.

Angiotensin II ; pharmacology ; Animals ; Base Sequence ; Cell Division ; Collagen ; biosynthesis ; Liver ; cytology ; metabolism ; Liver Cirrhosis ; etiology ; Molecular Sequence Data ; Proline ; metabolism ; RNA, Messenger ; analysis ; Rats ; Receptor, Angiotensin, Type 1 ; genetics