Consolini R, Legitimo A, Rondelli R, Guguelmi C, Barisone E, Lippi A, Cantù-Rajnoldi A, Aricò M, Conter V, Cocito M G, Putti M C, Pession A, Masera G, Biondi A, Basso G
Istituto di Clinica Pediatrica, Università di Pisa.
Haematologica. 1998 Nov;83(11):967-73.
Previous studies have considered the prognostic significance of CD10 expression in childhood acute lymphoblastic leukemia (ALL) and showed its linkage to a more favorable prognosis. The aim of this study was to assess the independent significance of CD10 expression in a large population of ALL patients.
We revised the independent clinical relevance of CD10 expression in 2038 children with acute lymphoblastic leukemia (ALL), who were consecutively entered in 4 sequential trials of the Italian Association for Pediatric Hematology and Oncology (i.e. AIEOP studies 82, 87, 88, 91); 1142 were males and 896 females, age ranged between 1 and 14 years (yrs) at diagnosis. Of the whole group, 1471 children (72.2%) were defined as having standard risk, 567 (27.8%) as having a high risk.
CD10 was detected in blast cells from 1706 of 1784 (95.6%) patients with B-lineage ALL and 46 of 254 (18.1%) with T-cell ALL. In the B-lineage subgroup CD10 expression was associated with presenting features such as age < 9 yrs and inclusion in the standard risk category. No significant differences were found between CD10+ and CD10- cases in T-lineage ALL, concerning presenting features, except for FAB L2 in the former group. We compared the event-free survival (EFS) rates for patients with T-ALL or B-lineage ALL, regarding CD10 positivity, overall and by individual study. Patients with T-ALL fared worse than those with B-lineage ALL (5 and 10 yrs EFS: 46.8% vs. 68.5% and 44.5% vs. 63.7% respectively, p = 0.0001). In multivariate analysis of B-lineage subgroup poorer EFS was associated with male sex, higher WBC (> or = 20 x 10(9)/L), age > 9 yrs. Only WBC > or = 20 x 10(9)/L and age > 9 yrs were parameters linked to poorer EFS in the T-lineage subgroup. Finally, we compared EFS rates for four groups of patients categorized as having high or standard risk, and according to CD10+ and CD10- expression. High-risk patients fared statistically worse than standard risk patients both in the CD10- and in the CD10+ groups (42% vs. 50.7% and 63.6% vs. 66.8%, respectively).
CD10 expression does not have independent prognostic significance in either the larger subgroup of B-ALL patients or in T-cell ALL.
既往研究探讨了CD10表达在儿童急性淋巴细胞白血病（ALL）中的预后意义，并表明其与更有利的预后相关。本研究旨在评估CD10表达在大量ALL患者中的独立意义。
我们回顾了2038例急性淋巴细胞白血病（ALL）患儿中CD10表达的独立临床相关性，这些患儿连续纳入了意大利儿科血液学和肿瘤学协会的4项连续试验（即AIEOP研究82、87、88、91）；1142例为男性，896例为女性，诊断时年龄在1至14岁之间。在整个队列中，1471例患儿（72.2%）被定义为标准风险，567例（27.8%）为高风险。
在1784例B系ALL患者中的1706例（95.6%）和254例T细胞ALL患者中的46例（18.1%）的原始细胞中检测到CD10。在B系亚组中，CD10表达与年龄<9岁和纳入标准风险类别等表现特征相关。在T系ALL中，CD10阳性和阴性病例之间在表现特征方面未发现显著差异，但前者组中FAB L2除外。我们比较了T-ALL或B系ALL患者中CD10阳性、总体及各研究的无事件生存率（EFS）。T-ALL患者的预后比B系ALL患者差（5年和10年EFS：分别为46.8%对68.5%和44.5%对63.7%，p = 0.0001）。在B系亚组的多因素分析中，较差的EFS与男性、较高的白细胞计数（≥20×10⁹/L）、年龄>9岁相关。在T系亚组中，只有白细胞计数≥20×10⁹/L和年龄>9岁是与较差EFS相关的参数。最后，我们比较了分为高风险或标准风险且根据CD10阳性和阴性表达的四组患者的EFS率。高风险患者在CD10阴性组和CD10阳性组中的预后均在统计学上比标准风险患者差（分别为42%对50.7%和63.6%对66.8%）。
CD10表达在B-ALL患者的较大亚组或T细胞ALL中均无独立的预后意义。
