| Abstract: |
Leukemic cells from most patients with B-lineage acute lymphoblastic leukemia (ALL) appear to originate from normal B-lymphocyte precursors. The earliest B-cell progenitors co-express the antigens CD10, CD19, or CD34 on their cell surfaces. In a large cohort of 2028 children with ALL, we compared treatment outcomes of a subset of B-lineage ALL patients with CD10+CD19+CD34+ immature B-progenitor leukemia (BPL) to the treatment outcomes of the remaining CD19+ B-lineage ALL patients. Pediatric B-lineage ALL cases enrolled on risk-adjusted ALL treatment protocols of the Children's Cancer Group were immunophenotypically classified as BPL or non-BPL. Patients were stratified further into age groups of ≤ 1 year and < 12 months. Event-free survival (EFS) outcomes were calculated by standard life table methods. BPL patients in both age groups generally had more favorable presenting characteristics than non-BPL controls. Within the age group of ≤ 1 year, BPL patients had a slightly better EFS outcome than non-BPL patients, with 3-year estimates of 83.9% (SD = 1.1%) vs. 78.8% (SD = 1.8%), respectively (P = 0.10). Infants with BPL, representing one-fifth of the total infant patient population, had a significantly better EFS outcome than infants with non-BPL (three-year EFS: 82.4%, SD = 9.2% vs. 34.4%, SD = 5.9%, P = 0.006). In univariate analyses, the relative hazard rate (RHR) was 3.73 for non-BPL vs BPL and this marked difference in EFS outcome was maintained at 5 years of follow-up. The favorable prognostic influence of the BPL immunophenotype for infants remained significant in multivariate analyses with an RHR of 2.72 for non-BPL vs BPL (P = 0.05). CD10+CD19+CD34+ immature B-progenitor immunophenotype is associated with favorable characteristics for children with ALL and identifies a subset of infants who achieve favorable EFS outcomes. |
| Keywords: |
adult; child; treatment outcome; child, preschool; survival analysis; human cell; major clinical study; cd34 antigen; acute lymphoblastic leukemia; statistical analysis; antigens, neoplasm; infant; infant, newborn; leukemia cell; immunophenotyping; multivariate analysis; antigens, cd; children; childhood leukemia; antigens, cd34; cd19 antigen; antigens, cd19; pre b lymphocyte; common acute lymphoblastic leukemia antigen; lymphocyte subpopulation; leukemia, lymphocytic, acute, l1; neprilysin; humans; prognosis; human; male; female; priority journal; article; b-progenitor immunophenotype; cd10+ cd19+ cd34+ all; leukemia, b-cell, acute
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