Zhang Lu-Yang, Chen Xiao-Juan, Wang Shu-Chun, Guo Ye, Yang Wen-Yu, Chen Yu-Mei, Zhang Li, Zou Yao, Zhu Xiao-Fan
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):728-733. doi: 10.7499/j.issn.1008-8830.2001095.
To study the significance of CD20 combined with white blood cell (WBC) count at diagnosis in the prognosis assessment in children with B-lineage acute lymphoblastic leukemia (ALL).
A retrospective analysis was performed on the medical data of 821 B-ALL children who were treated with CCLG-ALL2008 regimen from April 2008 to April 2015. Their survival status was followed up.
Among the 821 children, 547 (66.6%) were negative, while 274 (33.4%) were positive for CD20 expression. Among 694 children with WBC<50×10/L (lower WBC count), the 5-year EFS rates were 65.9%±3.2% and 77.3%±2.0% for CD20 positive and negative patients respectively (P=0.001); the 5-year OS rates were 78.3%±2.9% and 87.5%±1.6% for CD20 positive and negative patients respectively (P=0.005); CD20 positive expression was an independent risk factor for EFS (HR=1.634, P=0.001) and OS (HR=1.761, P=0.005). Among 127 children with WBC>50×10/L (higher WBC count), the 5-year EFS rates was 64.3%±7.7% and 53.7%±5.5% for CD20 positive and negative patients respectively (P=0.135); the 5-year OS rate was 81.4%±6.4% and 58.6%±5.6% for CD20 positive and negative patients respectively (P=0.022); CD20 positive expression was an independent protective factor for OS (HR=0.367, P=0.016).
In children with B-ALL who are treated with CCLG-ALL2008 regimen, those with CD20 positive expression in lower WBC count at diagnosis have a poor prognosis; however, those with CD20 positive expression in higher WBC count at diagnosis have a better long-time survival.
探讨CD20联合白细胞（WBC）计数在B系急性淋巴细胞白血病（ALL）患儿诊断时对预后评估的意义。
回顾性分析2008年4月至2015年4月采用CCLG-ALL2008方案治疗的821例B-ALL患儿的临床资料，并对其生存状况进行随访。
821例患儿中，CD20表达阴性者547例（66.6%），阳性者274例（33.4%）。在694例白细胞计数<50×10⁹/L（低白细胞计数）的患儿中，CD20阳性和阴性患儿的5年无事件生存率（EFS）分别为65.9%±3.2%和77.3%±2.0%（P=0.001）；5年总生存率（OS）分别为78.3%±2.9%和87.5%±1.6%（P=0.005）；CD20阳性表达是EFS（风险比[HR]=1.634，P=0.001）和OS（HR=1.761，P=0.005）的独立危险因素。在127例白细胞计数>50×10⁹/L（高白细胞计数）的患儿中，CD20阳性和阴性患儿的5年EFS分别为64.3%±7.7%和53.7%±5.5%（P=0.135）；5年OS分别为81.4%±6.4%和58.6%±5.6%（P=0.022）；CD20阳性表达是OS的独立保护因素（HR=0.367，P=0.016）。
采用CCLG-ALL2008方案治疗的B-ALL患儿，诊断时白细胞计数低且CD20阳性表达者预后较差；而诊断时白细胞计数高且CD20阳性表达者长期生存较好。
