Affiliations: Department of Hematology-oncology, Children’s Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Research Center for the Diagnosis and Treatment Technology of Childhood Leukemia, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
Correspondence:
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Corresponding author: Yong-Min Tang, Department of Hematology-Oncology, Children’s Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Research Center for the Diagnosis and Treatment Technology of Childhood Leukemia, National Clinical Research Center For Child Health, #57 Zhuganxiang Road, Yan-an Street, Hangzhou, Zhejiang 310003, China. Tel.: +86 571 88873450; Fax: +86 571 87033296; E-mail: [email protected].
Abstract: BACKGROUND: Prognostic factors are not well exploited in childhood T-cell acute lymphoblastic leukemia (T-ALL). OBJECTIVE: The aim of this study was to analyze the prognostic role of CD38 as well as minimal residual disease (MRD) and other biological factors in T-ALL. METHODS: Immunophenotyping of bone marrow (BM) at diagnosis and MRD levels were determined using a standard panel of antibodies by 4-colour flow cytometry. A total of 96 children with T-ALL were enrolled. RESULTS: The results showed that 97.9% of T-ALL patients were positive for CD38 with a median level of 85.3%. CD38-high group had a worse early treatment response than the CD38-low group. However, CD38 levels were not associated with prognosis, albeit CD38-high group had a worse 5-year event free survival rate (55.1% vs. 66.6%, P> 0.05) and a higher 5-year cumulative incidence of relapse (35.6% vs. 19.8%, P> 0.05). Very high MRD levels (> 10%) were related to the worse survival. Neither flow cytometry based minimal residual disease (MRD) levels nor CD38 expression levels showed significant relation to the hazard of relapse (P> 0.05). CONCLUSIONS: We conclude that T-ALL has a high level of CD38 expression which is not associated with prognosis. Very high MRD level (> 10%) is related to the worse survival, however, FCM based MRD detection does not convey a significant prognostic value.
