目的 研究儿童急性淋巴细胞白血病（acute lymphoblastic leukemia, ALL）中CD123的表达情况及其对急性B淋巴细胞白血病（B-ALL）患儿临床特征及预后的影响。 方法 回顾性分析2019年12月—2022年6月昆明医科大学附属儿童医院血液肿瘤科收治的251例ALL患儿的临床资料。根据初诊CD123表达情况，分为CD123+组与CD123-组，比较两组的临床特征及疗效，并分析影响预后的因素。 结果 251例ALL患儿中，CD123+ 146例（58.2%），B-ALL患儿CD123阳性表达率高于急性T淋巴细胞白血病患儿（P<0.05）。相较于CD123-组，CD123+组初诊时外周血白细胞计数、幼稚细胞百分比更低，更易合并超二倍体染色体核型，1~10岁患儿比例更高，不易合并E2A-PBX1融合基因（P<0.05）。多因素Cox比例风险回归模型分析结果显示，相较于>10岁组，1~10岁组B-ALL患儿总生存率更高（P<0.05）；相较于高危组，中危组B-ALL患儿无事件生存率更高（P<0.05）。 结论 CD123在B-ALL患儿中广泛表达，CD123阳性表达可能为儿童B-ALL预后良好的指标，对评估B-ALL患儿诱导缓解治疗及生存预后具有重要意义。
Abstract
Objective To investigate the expression of CD123 in children with acute lymphoblastic leukemia (ALL) and its effect on the clinical characteristics and prognosis of children with B-lineage acute lymphoblastic leukemia (B-ALL). Methods A retrospective analysis was conducted on the clinical data of 251 children with ALL who were admitted to the Department of Hematology and Oncology, Children's Hospital of Kunming Medical University, from December 2019 to June 2022. According to the expression of CD123 at initial diagnosis, the children were divided into CD123+ group and CD123- group, and the two groups were compared in terms of clinical characteristics and treatment outcome. The factors influencing the prognosis were analyzed. Results Among the 251 children with ALL, there were 146 children (58.2%) in the CD123+ group. The B-ALL group had a significantly higher positive expression rate of CD123 than the acute T lymphocyte leukemia group (P<0.05). Compared with the CD123- group, the CD123+ group had significantly lower peripheral blood leukocyte count and percentage of juvenile cells and a significantly higher proportion of children with high hyperdiploid karyotype or an age of 1-10 years, with a relatively low proportion of children with E2A-PBX1 fusion gene (P<0.05). The multivariate Cox proportional-hazards regression model analysis showed that compared with the >10 years group, the 1-10 years group had a significantly higher overall survival rate (P<0.05), and compared with the high risk group, the moderate risk group had a significantly higher event-free survival rate in children with B-ALL (P<0.05). Conclusions CD123 is widely expressed in children with B-ALL, and positive expression of CD123 might be an indicator for good prognosis in children with B-ALL, which is of great significance for evaluating the efficacy of remission induction therapy and survival prognosis of children with B-ALL.
关键词
急性淋巴细胞白血病 /
白血病干细胞 /
CD123 /
预后 /
儿童
Key words
Acute lymphoblastic leukemia /
Leukemia stem cell /
CD123 /
Prognosis /
Child
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基金
云南省竺晓凡专家工作站（202105AF150070）。
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