Rivera-Luna R, Cardenas-Cardos R, Leal-Leal C, Navarro-Alegría I, Meza-Coria C, Gómez-Martínez R, Vega-Vega L
Departamento de Oncologia del Instituto Nacional de Pediatria, SS, México, D.F.
Arch Med Res. 1997 Summer;28(2):233-9.
A total of 119 children (1990-95) with acute lymphoblastic leukemia (ALL) B-lineage either CD10+ or CD10- were registered into a single non-randomized chemotherapy protocol. Only untreated patients with standard risk were included in the study. Their ages ranged from 1.8-10 years with a mean of 5.1 years. There were 82 (68%) children with early pre B-All, 35 (29%) with pre B-ALL and 2(1.6%) with transitional pre B-ALL (p < 0.00001). The patients were divided according to CD10 reactivity, either + (94 children) or -(25 patients). The event-free survival (EFS) at 60 months for the CD10+ children was of 78% (alive 73/94), while for the CD10- was 71% (alive 18/25) (p = 0.6) and 74% for both groups. The factors that influenced favorably the survival in the CD10+ group were the age between 3 to 5.99 years (p < 0.00001), sex (either male or female), leukocyte count between 10-24.9 x 10(9)/l (p < 0.00001), LDH under 300 U/I (p < 0.00001) and L1 bone marrow cytomorphology (p < 0.00001). In the CD10- patients, the EFS was favorably influenced by the female sex (p = 0.04), leukocyte count under 10 x 10(9)/l (p = 0.05) and LDH < 300 U/l (p = 0.02). CNS infiltration was documented in 4.2% (5/119). Mortality secondary to chemotherapy was seen in 7%. In conclusion, this is the first large series in Mexican children with B-lineage ALL published. Because of the relatively small number of patients in each group (pre B and transitional pre B), all the patients in the current series were treated alike. When the 119 patients were divided only on the basis of CD10 reactivity, the EFS for both groups (CD10+ and-) was similar; therefore, the reactivity to CD10 has no prognostic value in this type of ALL.
共有119名（1990 - 1995年）B系急性淋巴细胞白血病（ALL）患儿（CD10+或CD10-）登记进入单一非随机化疗方案。研究仅纳入标准风险的未治疗患者。他们的年龄在1.8至10岁之间，平均年龄为5.1岁。其中82名（68%）为早期前B-ALL患儿，35名（29%）为前B-ALL患儿，2名（1.6%）为过渡性前B-ALL患儿（p<0.00001）。患者根据CD10反应性分为阳性（94名患儿）或阴性（25名患者）两组。CD10+组患儿60个月时的无事件生存率（EFS）为78%（73/94存活），而CD10-组为71%（18/25存活）（p = 0.6），两组总体为74%。对CD10+组生存有有利影响的因素包括年龄在3至5.99岁之间（p<0.00001）、性别（男或女）、白细胞计数在10 - 24.9×10⁹/L之间（p<0.00001）、乳酸脱氢酶（LDH）低于300 U/I（p<0.00001）以及L1型骨髓细胞形态（p<0.00001）。在CD10-患者中，EFS受到女性性别（p = 0.04）、白细胞计数低于10×10⁹/L（p = 0.05）和LDH<300 U/L（p = 0.02）的有利影响。中枢神经系统浸润记录在4.2%（5/119）的患者中。化疗相关死亡率为7%。总之，这是墨西哥发表的关于B系ALL患儿的首个大型系列研究。由于每组（前B和过渡性前B）患者数量相对较少，本系列所有患者接受相同治疗。当119名患者仅根据CD10反应性分组时，两组（CD10+和CD-）的EFS相似；因此对于此类ALL，CD10反应性无预后价值。
