Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
Clin Lymphoma Myeloma Leuk. 2018 May;18(5):361-367. doi: 10.1016/j.clml.2018.02.013. Epub 2018 Feb 26.
The expression of the CD20 on adult B-cell acute lymphoblastic leukemia (ALL-B) has generally been associated with a poor prognosis, and several studies have explored the incorporation of rituximab into the therapeutic regimen for adult ALL-B patients, with a positive effect on event-free survival (EFS).
We analyzed the prognostic value of CD20 expression and the effect of rituximab for the treatment of Hispanic adult ALL-B patients. We performed a retrospective study of 152 ALL-B patients treated from 2009 to 2016. The patient characteristics and treatment outcomes were analyzed according to CD20 expression (CD20 vs. CD20), age group, and treatment with rituximab.
CD20 expression was positive for 47.7% of patients (n = 72). Excluding the patients who had received rituximab, the overall survival (OS) was greater for the CD20 patient subgroup than for the CD20 subgroup (11.2 vs. 6.9 months; 95% confidence interval [CI], 7.43-14.9; P = .008). In the CD20 subgroup, 10 patients (7.2%) received treatment with rituximab, with 100% reaching complete remission (CR) 4 weeks after treatment. In the 18- to 39-year age group, CD20 patients treated with rituximab had EFS and OS that was not reached. In addition, for CD20 patients who received with chemotherapy, EFS was 3.9 months (95% CI, 0.6-7.2 months; P = .025) and OS was 7.2 months (95% CI, 3.37-11.0; P = .013). Multivariate analysis showed that the use of rituximab was independently associated with OS and CR at 4 weeks after induction.
CD20 expression in adult ALL-B is associated with decreased OS. Treatment with rituximab can increase OS, EFS, and CR in the 18- to 39-year age group.
CD20 在成人 B 细胞急性淋巴细胞白血病（ALL-B）中的表达通常与预后不良相关，多项研究探索了将利妥昔单抗纳入成人 ALL-B 患者的治疗方案中，对无事件生存（EFS）有积极影响。
我们分析了 CD20 表达对西班牙裔成人 ALL-B 患者的预后价值以及利妥昔单抗治疗的效果。我们对 2009 年至 2016 年期间接受治疗的 152 例 ALL-B 患者进行了回顾性研究。根据 CD20 表达（CD20 vs. CD20）、年龄组和利妥昔单抗治疗情况分析患者特征和治疗结果。
72 例患者（47.7%）的 CD20 表达为阳性。排除接受利妥昔单抗治疗的患者后，CD20 患者亚组的总生存率（OS）高于 CD20 亚组（11.2 个月比 6.9 个月；95%置信区间[CI]，7.43-14.9；P=0.008）。在 CD20 亚组中，10 例（7.2%）患者接受利妥昔单抗治疗，治疗后 4 周均达到完全缓解（CR）。在 18 岁至 39 岁年龄组中，接受利妥昔单抗治疗的 CD20 患者的 EFS 和 OS 未达到。此外，对于接受化疗的 CD20 患者，EFS 为 3.9 个月（95%CI，0.6-7.2 个月；P=0.025），OS 为 7.2 个月（95%CI，3.37-11.0；P=0.013）。多变量分析显示，诱导后 4 周时使用利妥昔单抗与 OS 和 CR 独立相关。
成人 ALL-B 中的 CD20 表达与 OS 降低相关。利妥昔单抗治疗可提高 18 岁至 39 岁年龄组患者的 OS、EFS 和 CR。
