Laboratory Oncology Unit, Dr. BRAIRCH, AIIMS, New Delhi, India.
Department of Medical Oncology, Dr. BRAIRCH, AIIMS, New Delhi, India.
Blood Cells Mol Dis. 2021 Jul;89:102562. doi: 10.1016/j.bcmd.2021.102562. Epub 2021 Mar 16.
The treatment of pediatric acute lymphoblastic leukemias (ALL) has seen remarkable advances recently. However, relapse occurs in approximately 20% of cases which necessitates identifying additional high risk parameters for treatment intensification. The aim of this study is to assess the prognostic significance of CD45 antigen expression in pediatric ALL.
We studied 363 pediatric patients with B cell precursor-ALL (BCP-ALL) (n = 313) and T-ALL (n = 50). The ratio of median fluorescence intensity of CD45 expressed in leukemic blasts and normal lymphocytes was calculated. The 75th percentile was taken as cut-off to categorise patients into CD45 high and CD45 low groups.
The 75th percentile was 0.141 in BCP-ALL and 0.548 in T-ALL. In BCP-ALL, there was a statistically significant association of age (≥10 years) (p = 0.027) and National Cancer Institute high risk group (p = 0.001) with high CD45 expression but not in T-ALL. Worse event-free survival (EFS) was seen with high CD45 expression in BCP-ALL (42.17% versus 60.83%, p = 0.0053). In T-ALL, there was no association between CD45 expression and EFS (CD45 high 40.40% versus low 67.35%, p = 0.414). The overall survival (OS) was 70% versus 60% (p = 0.38) in BCP-ALL and the OS was 82% versus 68% (p = 0.16) in T-ALL for CD45 low versus CD45 high groups, respectively.
We conclude that high CD45 surface expression is associated with worse EFS in pediatric BCP-ALL.
儿童急性淋巴细胞白血病（ALL）的治疗最近取得了显著进展。然而，约有 20%的病例会复发，这需要确定其他高危参数来加强治疗。本研究旨在评估 CD45 抗原在儿童 ALL 中的表达的预后意义。
我们研究了 363 例 B 细胞前体急性淋巴细胞白血病（BCP-ALL）（n=313）和 T 细胞急性淋巴细胞白血病（T-ALL）（n=50）患儿。计算白血病细胞和正常淋巴细胞中 CD45 表达的中荧光强度的比值。采用第 75 百分位数作为界值将患者分为 CD45 高表达和 CD45 低表达组。
BCP-ALL 的第 75 百分位数为 0.141，T-ALL 为 0.548。在 BCP-ALL 中，高 CD45 表达与年龄（≥10 岁）（p=0.027）和国家癌症研究所高危组（p=0.001）显著相关，但在 T-ALL 中则没有。BCP-ALL 中高 CD45 表达与较差的无事件生存（EFS）相关（42.17%比 60.83%，p=0.0053）。在 T-ALL 中，CD45 表达与 EFS 之间无相关性（CD45 高组 40.40%比低组 67.35%，p=0.414）。BCP-ALL 中，CD45 低表达组的总生存（OS）为 70%，CD45 高表达组为 60%（p=0.38）；T-ALL 中，CD45 低表达组的 OS 为 82%，CD45 高表达组为 68%（p=0.16）。
我们的结论是，儿童 BCP-ALL 中高 CD45 表面表达与较差的 EFS 相关。
