Department of Pathology, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Adult Hematology-Oncology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Clin Lymphoma Myeloma Leuk. 2020 Sep;20(9):e560-e568. doi: 10.1016/j.clml.2020.04.008. Epub 2020 Apr 23.
In adult B cell precursor acute lymphoblastic leukemia (BCP-ALL), CD20 expression has generally been associated with an adverse prognosis. Incorporating rituximab to standard of care is found to improve the outcome of CD20 BCP-ALL. The aim of this study is to estimate the prognostic effect of CD20 expression and the impact of rituximab in BCP-ALL in Saudi Arabia.
We performed a retrospective study of 55 Saudi adult patients with BCP-ALL in King Fahad Specialist Hospital in Dammam from 2008 to 2017.
The proportion of CD20 cases was approximately 55%. Excluding rituximab-treated patients, the 5-year overall survival (OS) rate of CD20 patients was lower than CD20 patients (56% vs. 66%; P = .62). Among CD20 patients, the proportion that received rituximab was approximately 27%. Comparing CD20 patients with and without rituximab, all patients who received rituximab achieved complete remission (CR) 4 weeks post-induction. The 3-year OS rate (88% vs. 63%; P = .35) and the 2-year event-free survival rate (70% vs. 68%; P = .75) were in favor of rituximab. In univariate and multivariate analyses, CR 4 weeks post-induction is recognized as an independent predictor of outcome. However, differences in survival rates did not have a statistical significance.
CD20 expression in adult patients with BCP-ALL seems to be higher in Saudi Arabians than in Caucasians, and it seems to have a tendency towards an inferior outcome in terms of OS. Incorporating rituximab to standard of care seems to improve the outcome in terms of CR, OS, and event-free survival.
在成人 B 细胞前体急性淋巴细胞白血病（BCP-ALL）中，CD20 表达通常与不良预后相关。将利妥昔单抗纳入标准治疗可改善 CD20 BCP-ALL 的预后。本研究旨在评估 CD20 表达在沙特阿拉伯 BCP-ALL 中的预后作用和利妥昔单抗的影响。
我们对 2008 年至 2017 年在达曼法赫德国王专科医院的 55 例沙特成人 BCP-ALL 患者进行了回顾性研究。
CD20 病例的比例约为 55%。排除接受利妥昔单抗治疗的患者，CD20 患者的 5 年总生存率（OS）低于 CD20 患者（56% vs. 66%；P=.62）。在 CD20 患者中，接受利妥昔单抗治疗的比例约为 27%。比较接受和未接受利妥昔单抗治疗的 CD20 患者，所有接受利妥昔单抗治疗的患者在诱导后 4 周达到完全缓解（CR）。3 年 OS 率（88% vs. 63%；P=.35）和 2 年无事件生存率（70% vs. 68%；P=.75）均有利于利妥昔单抗。单因素和多因素分析均表明，诱导后 4 周达到 CR 是预后的独立预测因素。然而，生存率的差异无统计学意义。
在沙特阿拉伯的 BCP-ALL 成人患者中，CD20 表达似乎高于白种人，并且在 OS 方面似乎预后较差。将利妥昔单抗纳入标准治疗似乎可改善 CR、OS 和无事件生存率。
