Al-Zaabi Mohamed, Al-Khabori Murtadha, Fawaz Naglaa, Al-Lamki Sulayma, Al-Riyami Arwa, Al-Huneini Mohammed, Al-Muslahi Muhanna, Alkindi Salam
Hematology Residency Training Program, Oman Medical Specialty Board, Muscat, Oman.
Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman.
Oman Med J. 2017 May;32(3):189-193. doi: 10.5001/omj.2017.36.
To evaluate the impact of myeloid antigen expression on complete remission (CR), event-free survival (EFS), and overall survival (OS) in patients with T-cell acute lymphoblastic leukemia (T-ALL) treated with intensive chemotherapy.
We retrospectively reviewed consecutive patients diagnosed with T-ALL and treated in Sultan Qaboos University Hospital and Royal Hospital in Oman between 2004 and 2010. The diagnosis of T-ALL was established using French-American-British classification or World Health Organization criteria. Patients were considered having myeloid antigen expression if they expressed CD13, CD33, or both (My+ and My-).
Of the 39 patients, 38 were included in the study (25 patients with My- and median age of 18.4 years, 13 patients with My+ and median age of 22.0 years). Median follow-up was 12 months. Thirty-two out of the total cohort were eligible for response-rate assessment. Twenty-nine patients (90.6%) achieved CR with one or two courses of chemotherapy with similar CR rates between the two groups ( 0.880). Twenty-five percent (5/20) of the patients with My- required two courses of induction, whereas 58.3% (7/12) of My+ required two courses of induction and the difference was statistically significant ( 0.040). In the multivariable analysis; age, gender, initial white blood cell count, central nervous system disease, and myeloid antigen expression were not statistically significant predictors of CR. The EFS and OS were similar between the My+ and My- groups 0.180 and 0.440, respectively.
Patients with T-ALL with myeloid antigen expression need more courses of induction; however, rates of CR, EFS, and OS are not different from those without myeloid antigen expression. Larger prospective studies are required to confirm these findings.
评估髓系抗原表达对接受强化化疗的T细胞急性淋巴细胞白血病（T-ALL）患者完全缓解（CR）、无事件生存期（EFS）和总生存期（OS）的影响。
我们回顾性分析了2004年至2010年间在阿曼苏丹卡布斯大学医院和皇家医院确诊并接受治疗的连续性T-ALL患者。T-ALL的诊断依据法国-美国-英国分类法或世界卫生组织标准确定。如果患者表达CD13、CD33或两者均表达（My+和My-），则被认为有髓系抗原表达。
39例患者中，38例纳入研究（25例My-患者，中位年龄18.4岁；13例My+患者，中位年龄22.0岁）。中位随访时间为12个月。总队列中有32例符合缓解率评估标准。29例患者（90.6%）在接受一或两个疗程化疗后达到CR，两组CR率相似（P=0.880）。My-患者中有25%（5/20）需要两个疗程诱导治疗，而My+患者中有58.3%（7/12）需要两个疗程诱导治疗，差异有统计学意义（P=0.040）。在多变量分析中，年龄、性别、初始白细胞计数、中枢神经系统疾病和髓系抗原表达不是CR的统计学显著预测因素。My+组和My-组的EFS和OS相似，分别为P=0.180和P=0.440。
有髓系抗原表达的T-ALL患者需要更多疗程的诱导治疗；然而，CR、EFS和OS率与无髓系抗原表达的患者并无差异。需要更大规模的前瞻性研究来证实这些发现。
