Herold Ralf, Stibenz Dietger, Hartmann Reinhard, Henze Günter, Bührer Christoph
Paediatric Oncology-Haematology and Neonatology, Otto-Heubner-Centre for Paediatric and Adolescent Medicine, Charité, Virchow Medical Centre, Humboldt University, Berlin, Germany.
Br J Haematol. 2002 Dec;119(3):677-84. doi: 10.1046/j.1365-2141.2002.03897.x.
Soluble l-selectin (sCD62L) plasma concentrations at diagnosis and outcome were investigated in 193 children at first relapse of acute lymphoblastic leukaemia (ALL) after treatment according to the Berlin-Frankfurt-Münster relapsed ALL multicentre trials, ALL-REZ BFM 95 and 96. sCD62L was low (< fifth paediatric reference percentile) in 63 (33%) and high (> 95th percentile) in 36 (19%) children, and was independent of remission duration, sex, BCR-ABL fusion or extramedullary disease. High sCD62L was associated with circulating blasts and T-cell phenotype. More initial adverse events occurred in children with high and low levels of sCD62L (23 out of 99) than in those with normal levels (9 out of 94, P = 0.018). Among 75 worst-prognosis patients (risk groups S3/S4, isolated bone marrow relapse occurring less than 6 months after elective cessation of front-line therapy, or T-cell phenotype with bone marrow involvement), 27 had low sCD62L and decreased event-free survival (EFS) probability (PEFS5 = 0.09 at 5 years) and duration (219 d) compared with normal sCD62L (29 out of 75, PEFS5 = 0.24, 640 d, P = 0.01). Low (44 out of 118), normal (72 out of 118), and high (19 out of 118) sCD62L non-S3/S4 patients fared similarly (average PEFS5 = 0.45, 1369 d; P = 0.5). Low sCD62L may be a marker of malignant blasts replacing normal sCD62L-producing haematopoietic cells. In children with first relapse of ALL and worst prognosis, plasma sCD62L may be useful for risk-adapted stratification.
根据柏林-法兰克福-明斯特复发性急性淋巴细胞白血病（ALL）多中心试验ALL-REZ BFM 95和96，对193例首次复发的急性淋巴细胞白血病儿童在诊断时和治疗后的结局进行了可溶性L-选择素（sCD62L）血浆浓度的研究。63例（33%）儿童的sCD62L水平较低（<第五个儿科参考百分位数），36例（19%）儿童的sCD62L水平较高（>第95百分位数），且其与缓解持续时间、性别、BCR-ABL融合或髓外疾病无关。高sCD62L与循环原始细胞和T细胞表型相关。sCD62L水平高和低的儿童（99例中的23例）比sCD62L水平正常的儿童（94例中的9例）发生的初始不良事件更多（P = 0.018）。在75例预后最差的患者（风险组S3/S4、一线治疗选择性停止后不到6个月发生的孤立骨髓复发，或伴有骨髓受累的T细胞表型）中，27例sCD62L水平低，其无事件生存期（EFS）概率（5年时PEFS5 = 0.09）和持续时间（219天）低于sCD62L水平正常的患者（75例中的29例，PEFS5 = 0.24，640天，P = 0.01）。sCD62L水平低（118例中的44例）、正常（118例中的72例）和高（118例中的19例）的非S3/S4患者的情况相似（平均PEFS5 = 0.45，1369天；P = 0.5）。低sCD62L可能是恶性原始细胞取代产生正常sCD62L的造血细胞的一个标志物。在首次复发且预后最差的ALL儿童中，血浆sCD62L可能有助于进行风险适应性分层。
