Orgad S, Cohen I J, Neumann Y, Vogel R, Kende G, Ramot B, Zaizov R, Gazit E
Division of Transplantation Immunology, Sheba Medical Center, Tel-Hashomer, Israel.
Leukemia. 1988 Dec;2(12 Suppl):79S-87S.
A possible association between HLA antigens, susceptibility or resistance to leukemia, and responsiveness to treatment has been studied in 144 patients with childhood acute lymphoblastic leukemia (ALL) and compared to other prognostic factors, i.e. white blood cell (WBC) counts, age at onset, sex, ethnic origin, and cell surface markers. All sequentially newly diagnosed children (97) comprised the group for the prospective study (PSG) and were followed for 6 years. The group included 37 patients classified as T-ALL, 41 as CALLA+, 27 as NULL, 12 as B and pre-B, and 27 unclassified patients, who were diagnosed before 1980. During the follow-up period, 45 patients of the PSG died. Forty-seven patients designated long-term survivors (LTS) have been followed 6-20 years after diagnosis, having completed a 3-5 year course of anti-leukemia therapy, and having remained disease free thereafter. High WBC counts at diagnosis and T-cell-surface markers were associated with poor prognosis, as were enthnic origin and specific HLA antigens. Thus, there was one (1) a significant increase in HLA-A30 and a decrease in HLA B-14 in the PSG Jewish patients; and (2) a complete absence of HLA-ALL in LTS while, in the PSG, 8 of 9 HLA-All-positive patients died during the follow-up period. This suggests that HLA-All is associated with poor prognosis in childhood ALL.
对144例儿童急性淋巴细胞白血病（ALL）患者的人类白细胞抗原（HLA）、白血病易感性或抗性以及对治疗的反应性之间可能存在的关联进行了研究，并与其他预后因素进行了比较，这些因素包括白细胞（WBC）计数、发病年龄、性别、种族起源和细胞表面标志物。所有连续新诊断的儿童（97例）组成前瞻性研究组（PSG），随访6年。该组包括37例分类为T-ALL的患者、41例CALLA+患者、27例NULL患者、12例B和前B患者以及27例未分类患者，这些患者于1980年前被诊断。在随访期间，PSG组有45例患者死亡。47例被指定为长期存活者（LTS）的患者在诊断后6至20年接受了随访，他们完成了3至5年的抗白血病治疗疗程，此后一直无病。诊断时高白细胞计数和T细胞表面标志物与不良预后相关，种族起源和特定HLA抗原也是如此。因此，（1）PSG组犹太患者中HLA-A30显著增加，HLA B-14减少；（2）LTS组中完全没有HLA-ALL，而在PSG组中，9例HLA-ALL阳性患者中有8例在随访期间死亡。这表明HLA-ALL与儿童ALL的不良预后相关。
