Association of cerebrospinal fluid status with prognosis in children with acute lymphoblastic leukemia
YANG Wen-Yu, GUO Ye, CHEN Xiao-Juan, LIU Li-Peng, LIU Tian-Feng, LIU Fang, RUAN Min, WANG Shu-Chun, ZHANG Li, LIU Xiao-Ming, QI Ben-Quan, CHANG Li-Xian, ZOU Yao, CHEN Yu-Mei, ZHU Xiao-Fan
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology&Blood Diseases Hospital, Chinese Academy of Medical Sciences&Peking Union Medical College, Tianjin 300020, China
Abstract Objective To study the clinical features of central nervous system infiltration-positive (CNSI+) children with acute lymphoblastic leukemia (ALL) based on flow cytometry, as well as the association of such clinical features with prognosis. Methods A retrospective analysis was performed for the clinical data of 66 CNSI+ children with ALL treated from April 2008 to June 2013. Clinical features, laboratory examination results and prognosis were compared between the children in different chemotherapy stages (induction stage and consolidation/maintenance stage). Results Among the 66 CNSI+ children, 50 were in the induction stage and 16 in the consolidation/maintenance stage. Compared with the CNSI+ children in the induction stage, the CNSI+ children in the consolidation/maintenance stage had a significantly higher proportion of children with the genes associated with good prognosis based on the results of molecular biology (P < 0.05), as well as a significantly higher recurrence rate (P < 0.05). Recurrence was observed in 21 CNSI+ ALL children, among whom 10 were in the induction stage and 11 were in the consolidation/maintenance stage. Compared with the children experiencing recurrence in the induction stage, the children experiencing recurrence in the consolidation/maintenance stage had a significantly higher proportion of children with recurrence of the central nervous system and bone marrow (P < 0.05), as well as significantly higher proportion of biochemical positive rate of cerebrospinal fluid (P < 0.05). The children in the induction stage had a significantly higher recurrence-free survival rate than those in the consolidation/maintenance stage (P < 0.001), while there was no significant difference in overall survival rate between the two groups (P > 0.05). Conclusions In children with ALL, CNSI+ has a marked effect on recurrencefree survival rate in different chemotherapy stages, but has no obvious effect on overall survival rate. CNSI+ patients in the consolidation/maintenance stage have a higher recurrence.
YANG Wen-Yu,GUO Ye,CHEN Xiao-Juan et al. Association of cerebrospinal fluid status with prognosis in children with acute lymphoblastic leukemia[J]. CJCP, 2020, 22(4): 350-354.
YANG Wen-Yu,GUO Ye,CHEN Xiao-Juan et al. Association of cerebrospinal fluid status with prognosis in children with acute lymphoblastic leukemia[J]. CJCP, 2020, 22(4): 350-354.
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