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.
Arai N, Homma M, Abe M, et al. Impact of CD123 expression, analyzed by immunohistochemistry, on clinical outcomes in patients with acute myeloid leukemia[J]. Int J Hematol, 2019, 109(5): 539-544. PMID: 30847774. DOI: 10.1007/s12185-019-02616-y.
Angelova E, Audette C, Kovtun Y, et al. CD123 expression patterns and selective targeting with a CD123-targeted antibody-drug conjugate (IMGN632) in acute lymphoblastic leukemia[J]. Haematologica, 2019, 104(4): 749-755. PMID: 30361418. PMCID: PMC6442980. DOI: 10.3324/haematol.2018.205252.
Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia[J]. Blood, 2016, 127(20): 2391-2405. PMID: 27069254. DOI: 10.1182/blood-2016-03-643544.
Sun W, Malvar J, Sposto R, et al. Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study[J]. Leukemia, 2018, 32(11): 2316-2325. PMID: 29728694. PMCID: PMC6224404. DOI: 10.1038/s41375-018-0094-0.
Kandeel EZ, Madney Y, Eldin DN, et al. Overexpression of CD200 and CD123 is a major influential factor in the clinical course of pediatric acute myeloid leukemia[J]. Exp Mol Pathol, 2021, 118: 104597. PMID: 33358743. DOI: 10.1016/j.yexmp.2020.104597.
Das N, Gupta R, Gupta SK, et al. A real-world perspective of CD123 expression in acute leukemia as promising biomarker to predict treatment outcome in B-ALL and AML[J]. Clin Lymphoma Myeloma Leuk, 2020, 20(10): e673-e684. PMID: 32561191. DOI: 10.1016/j.clml.2020.05.004.
Li Z, Chu X, Gao L, et al. High expression of interleukin-3 receptor alpha chain (CD123) predicts favorable outcome in pediatric B-cell acute lymphoblastic leukemia lacking prognosis-defining genomic aberrations[J]. Front Oncol, 2021, 11: 614420. PMID: 33796456. PMCID: PMC8008053. DOI: 10.3389/fonc.2021.614420.
Bras AE, de Haas V, van Stigt A, et al. CD123 expression levels in 846 acute leukemia patients based on standardized immunophenotyping[J]. Cytometry B Clin Cytom, 2019, 96(2): 134-142. PMID: 30450744. PMCID: PMC6587863. DOI: 10.1002/cyto.b.21745.
