Bommannan Karthik, Arumugam Jhansi Rani, Radhakrishnan Venkatraman, Kalaiyarasi Jayachandran Perumal, Karunakaran Parathan, Mehra Nikita, Sagar Tenali Gnana, Sundersingh Shirley
Departments of Oncopathology, Cancer Institute (W.I.A.), Adyar, India.
Departments of Medical Oncology, Cancer Institute (W.I.A.), Adyar, India.
Blood Res. 2022 Sep 30;57(3):175-196. doi: 10.5045/br.2022.2022104. Epub 2022 Jul 27.
T-lymphoblastic leukemia (T-ALL) patients expressing myeloid/stem cell antigens are classified as early T-cell precursor lymphoblastic leukemia (ETP-ALL) or near-ETP-ALL.
Clinico-laboratory profiles, flow cytometric end-of-induction measurable residual disease (EOI-MRD), and survival of treatment naïve T-ALL patients were analyzed according to their immunophenotypic subtypes.
Among 81 consecutive T-ALL patients diagnosed, 21% (N=17) were ETP-ALL and 19% (N=15) were near-ETP-ALL. EOI-MRD was detectable in 39% of the 59 samples tested (31.6% of pediatric samples and 52.4% of adult samples). The frequency of EOI-MRD positivity was significantly higher among ETP-ALL (75%, =0.001) and near-ETP-ALL (71%, =0.009) patients compared to that in conventional-T-ALL (con-T-ALL) patients (22.5%). CD8 (P=0.046) and CD38 (P=0.046) expressions were significantly upregulated in the EOI blasts of con-T-ALL and ETP-ALL samples, respectively. The 2-year rates of overall (OS), relapse-free (RFS), and event-free survival (EFS) among the T-ALL patients (pediatric vs. adult) was 79.5% vs. 39.8% (<0.001), 84.3% vs. 60.4% (=0.026), and 80.3% vs. 38% (<0.001), respectively. Univariate analysis revealed that 2-year EFS and RFS of pediatric T-ALL patients was independent of T-ALL subtype and was influenced only by EOI-MRD status. However, 2-year OS, RFS, and EFS among adult T-ALL patients were EOI-MRD independent and influenced only by the near-ETP-ALL phenotype.
Two-year survival among pediatric and adult T-ALL patients is attributed to EOI-MRD status and near-ETP-ALL phenotype, respectively.
表达髓系/干细胞抗原的T淋巴细胞白血病（T-ALL）患者被归类为早期T细胞前体淋巴细胞白血病（ETP-ALL）或近ETP-ALL。
根据初治T-ALL患者的免疫表型亚型分析其临床实验室特征、流式细胞术诱导结束时的微小残留病（EOI-MRD）及生存情况。
在连续诊断的81例T-ALL患者中，21%（N = 17）为ETP-ALL，19%（N = 15）为近ETP-ALL。在检测的59份样本中，39%可检测到EOI-MRD（儿科样本为31.6%，成人样本为52.4%）。与传统T-ALL（con-T-ALL）患者（22.5%）相比，ETP-ALL患者（75%，P = 0.001）和近ETP-ALL患者（71%，P = 0.009）中EOI-MRD阳性频率显著更高。CD8（P = 0.046）和CD38（P = 0.046）表达分别在con-T-ALL和ETP-ALL样本的EOI原始细胞中显著上调。T-ALL患者（儿科与成人）的2年总生存率（OS）、无复发生存率（RFS）和无事件生存率（EFS）分别为79.5%对39.8%（P < 0.001）、84.3%对60.4%（P = 0.026）和80.3%对38%（P < 0.001）。单因素分析显示，儿科T-ALL患者的2年EFS和RFS与T-ALL亚型无关，仅受EOI-MRD状态影响。然而，成人T-ALL患者的2年OS、RFS和EFS与EOI-MRD无关，仅受近ETP-ALL表型影响。
儿科和成人T-ALL患者的2年生存率分别归因于EOI-MRD状态和近ETP-ALL表型。
