Risk factors for recurrence of childhood acute lymphoblastic leukemia after treatment with the Chinese Children's Cancer Group ALL-2015 protocol

CHEN Xia; LEI Xiao-Ying; GUAN Xian-Min; DOU Ying; WEN Xian-Hao; GUO Yu-Xia; GAO Hui-Qin; YU Jie

doi:10.7499/j.issn.1008-8830.2401010

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (7) : 701-707. DOI: 10.7499/j.issn.1008-8830.2401010

CLINICAL RESEARCH

Risk factors for recurrence of childhood acute lymphoblastic leukemia after treatment with the Chinese Children's Cancer Group ALL-2015 protocol

CHEN Xia, LEI Xiao-Ying, GUAN Xian-Min, DOU Ying, WEN Xian-Hao, GUO Yu-Xia, GAO Hui-Qin, YU Jie

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Abstract

Objective To investigate the cumulative incidence of recurrence (CIR) in children with acute lymphoblastic leukemia (ALL) after treatment with the Chinese Children's Cancer Group ALL-2015 (CCCG-ALL-2015) protocol and the risk factors for recurrence. Methods A retrospective analysis was conducted on the clinical data of 852 children who were treated with the CCCG-ALL-2015 protocol from January 2015 to December 2019. CIR was calculated, and the risk factors for the recurrence of B-lineage acute lymphoblastic leukemia (B-ALL) were analyzed. Results Among the 852 children with ALL, 146 (17.1%) experienced recurrence, with an 8-year CIR of 19.8%±1.6%. There was no significant difference in 8-year CIR between the B-ALL group and the acute T lymphocyte leukemia group (P>0.05). For the 146 children with recurrence, recurrence was mainly observed in the very early stage (n=62, 42.5%) and the early stage (n=46, 31.5%), and there were 42 children with bone marrow recurrence alone (28.8%) in the very early stage and 27 children with bone marrow recurrence alone (18.5%) in the early stage. The Cox proportional-hazards regression model analysis showed that positive MLLr fusion gene (HR=4.177, 95%CI: 2.086-8.364, P<0.001) and minimal residual disease≥0.01% on day 46 (HR=2.013, 95%CI: 1.163-3.483, P=0.012) were independent risk factors for recurrence in children with B-ALL after treatment with the CCCG-ALL-2015 protocol. Conclusions There is still a relatively high recurrence rate in children with ALL after treatment with the CCCG-ALL-2015 protocol, mainly bone marrow recurrence alone in the very early stage and the early stage, and minimal residual disease≥0.01% on day 46 and positive MLLr fusion gene are closely associated with the recurrence of B-ALL.

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Acute lymphoblastic leukemia / Chinese Children's Cancer Group ALL-2015 protocol / Recurrence / Risk factor / Child

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CHEN Xia, LEI Xiao-Ying, GUAN Xian-Min, DOU Ying, WEN Xian-Hao, GUO Yu-Xia, GAO Hui-Qin, YU Jie. Risk factors for recurrence of childhood acute lymphoblastic leukemia after treatment with the Chinese Children's Cancer Group ALL-2015 protocol[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(7): 701-707 https://doi.org/10.7499/j.issn.1008-8830.2401010

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