Department of Laboratory Medicine, West China Second University Hospital, Sichuan University.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Medicine (Baltimore). 2021 Apr 16;100(15):e25548. doi: 10.1097/MD.0000000000025548.
Several studies have reported an association between the rapidity of reduction in peripheral blood blast count or recovery of normal hematopoiesis and treatment outcome during therapy in children with acute lymphoblastic leukemia (ALL). However, little is known about the impact of both of these aspects on prognosis in pediatric ALL. Accordingly, the purpose of this study was to evaluate whether the combined use of blood blast count and platelet count could predict event-free survival (EFS) and overall survival (OS) when minimal residual disease (MRD) detection was not available.A total of 419 patients aged 0 to 14 years diagnosed and treated for ALL between 2011 and 2015 were enrolled.Patients with a blast count ≥0.1 × 109/L on day 8 exhibited significantly lower survival rates than that in those with blast counts <0.1 × 109/L. The EFS and OS in patients with platelet count ≥100 × 109/L on day 33 were significantly higher than those with platelet counts <100 × 109/L. In univariate and multivariate analyses, patients with low blast count on day 8 and high platelet count on day 33 were significantly associated with better EFS and OS. The combination of blast cell count on day 8 and platelet count on day 33 demonstrated a strong association with MRD-based risk stratification.Complete blood count is an inexpensive, easy to perform, and reliable measurement in children with ALL. The combination of blast count and platelet count during and after induction chemotherapy was a significant and independent prognostic factor for treatment outcome in pediatric ALL.
几项研究报告称，在儿童急性淋巴细胞白血病 (ALL) 治疗过程中，外周血原始细胞计数的快速减少或正常造血的恢复与治疗结果之间存在关联。然而，对于这两个方面对儿科 ALL 预后的影响知之甚少。因此，本研究旨在评估在无法检测微小残留病 (MRD) 的情况下，联合使用血液原始细胞计数和血小板计数是否可以预测无事件生存 (EFS) 和总生存 (OS)。
共纳入 2011 年至 2015 年间诊断和治疗的 419 名 0 至 14 岁的 ALL 患者。第 8 天原始细胞计数≥0.1×109/L 的患者的生存率明显低于原始细胞计数<0.1×109/L 的患者。第 33 天血小板计数≥100×109/L 的患者的 EFS 和 OS 明显高于血小板计数<100×109/L 的患者。单因素和多因素分析显示，第 8 天原始细胞计数低和第 33 天血小板计数高的患者 EFS 和 OS 明显较好。第 8 天原始细胞计数和第 33 天血小板计数的组合与基于 MRD 的危险分层具有很强的关联。
全血细胞计数是儿童 ALL 中一种廉价、易于进行且可靠的测量方法。诱导化疗期间和之后的原始细胞计数和血小板计数的组合是儿童 ALL 治疗结果的一个重要且独立的预后因素。
