Long-term clinical effect of the CCLG-ALL2008 regimen in treatment of childhood acute lymphoblastic leukemia with different molecular biological features
CHEN Xiao-Juan, ZOU Yao, LIU Xiao-Ming, YANG Wen-Yu, GUO Ye, RUAN Min, LIU Fang, CHEN Yu-Mei, ZHANG Li, WANG Shu-Chun, ZHU Xiao-Fan
Institute of Hematology, Blood Disease Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin 300020, China
Abstract Objective To study the long-term clinical effect of the CCLG-ALL2008 regimen in the treatment of children newly diagnosed with acute lymphoblastic leukemia (ALL) with different molecular biological features. Methods A total of 940 children who were newly diagnosed with ALL were enrolled in this study. The children were treated with the CCLG-ALL2008 regimen. A retrospective analysis was performed for the long-term outcome of ALL children with different molecular biological features. Results Among the 940 children with ALL, there were 570 boys and 370 girls, with a median age of onset of 5 years (range 1-15 years) and a median follow-up time of 65 months (range 3-123 months). The complete response (CR) rate was 96.7%, the predicted 10-year overall survival (OS) rate was 76.5%±1.5%, and the event-free survival (EFS) rate was 62.6%±3.0%. After CR was achieved after treatment, the overall recurrence rate was 21.9%. The children with positive ETV6-RUNX1 had the lowest recurrence rate and were prone to late recurrence, and those with positive MLL rearrangement had the highest recurrence rate and were prone to early recurrence. The children with positive ETV6-RUNX1 had a significantly higher predicted 10-year OS rate than those with positive TCF3-PBX1, BCR-ABL, or MLL rearrangement and those without molecular biological features (P P Conclusions Molecular biological features may affect the long-term prognosis of children with ALL, and positive MLL rearrangement and BCR-ABL fusion gene are indicators of poor prognosis. Children with positive ETV6-RUNX1 fusion gene have the highest long-term survival rate.
CHEN Xiao-Juan,ZOU Yao,LIU Xiao-Ming et al. Long-term clinical effect of the CCLG-ALL2008 regimen in treatment of childhood acute lymphoblastic leukemia with different molecular biological features[J]. CJCP, 2019, 21(9): 890-893.
CHEN Xiao-Juan,ZOU Yao,LIU Xiao-Ming et al. Long-term clinical effect of the CCLG-ALL2008 regimen in treatment of childhood acute lymphoblastic leukemia with different molecular biological features[J]. CJCP, 2019, 21(9): 890-893.
Cui L, Li ZG, Chai YH, et al. Outcome of children with newly diagnosed acute lymphoblastic leukemia treated with CCLG-ALL 2008:The first nation-wide prospective multicenter study in China[J]. Am J Hematol, 2018, 93(7):913-920.
Pui CH, Yang JJ, Hunger SP, et al. Childhood acute lymphoblastic leukemia:progress through collaboration[J]. J Clin Oncol, 2015, 33(27):2938-2948.
[7]
Asai D, Imamura T, Yamashita Y, et al. Outcome of TCF3-PBX1 positive pediatric acute lymphoblastic leukemia patients in Japan:a collaborative study of Japan Association of Childhood Leukemia Study (JACLS) and Children's Cancer and Leukemia Study Group (CCLSG)[J]. Cancer Med, 2014, 3(3):623-631.
[8]
Pui CH, Mullighan CG, Evans WE, et al. Pediatric acute lymphoblastic leukemia:where are we going and how do we get there?[J]. Blood, 2012, 120(6):1165-1174.
Pui CH, Campana D. Minimal residual disease in pediatric ALL[J]. Oncotarget, 2017, 8(45):78251-78252.
[15]
Mullighan CG, Su X, Zhang J, et al. Deletion of IKZF1 and prognosis in acute lymphoblastic leukemia[J]. N Engl J Med, 2009, 360(5):470-480.
[16]
Den Boer ML, van Slegtenhorst M, De Menezes RX, et al. A subtype of childhood acute lymphoblastic leukaemia with poor treatment outcome:a genome-wide classification study[J]. Lancet Oncol, 2009, 10(2):125-134.
[17]
Schmiegelow K, Levinsen MF, Attarbaschi A, et al. Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia[J]. J Clin Oncol, 2013, 31(19):2469-2476.
[18]
Pui CH, Yang JJ, Hunger SP, et al. Childhood acute lymphoblastic leukemia:progress through collaboration[J]. J Clin Oncol, 2015, 33(27):2938-2948.
[19]
Pui CH, Pei D, Campana D, et al. A revised definition for cure of childhood acute lymphoblastic leukemia[J]. Leukemia, 2014, 28(12):2336-2343.
