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Prognostic significance of steroid response in pediatric acute lymphoblastic leukemia: The CCCG-ALL-2015 study

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机构: [1]Department of Hematology/Oncology, Pediatrics, the Second Hospital of Anhui Medical University, Hefei, China. [2]Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiaotong University of School of Medicine, Shanghai, China. [3]Department of Hematology/Oncology, Children's Hospital of Soochow University, Suzhou, China. [4]Department of Pediatrics, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China. [5]Department of Hematology/Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China. [6]Hematology/Oncology, West China Second Hospital of Sichuan University, Chengdu, China. [7]Department of Hematology/Oncology, Guangzhou Women and Children Health Care Center, Guangzhou, China. [8]Department of Hematology/Oncology, Children's Hospital of Fudan University, Shanghai, China. [9]Department of Hematology/Oncology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China. [10]Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China. [11]Department of Hematology/Oncology, Kunming Children's Hospital, Kunming, China. [12]Department of Pediatrics, Huazhong University of Science and Technology Tongji Medical College Union Hospital, Wuhan, China. [13]Department of Pediatrics, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, China. [14]Department of Pediatrics, Affiliated Hospital of Qingdao University, Qingdao, China. [15]Department of Hematology Oncology, Children's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China. [16]Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong Children's Hospital, Hong Kong, China. [17]Department of Pediatrics, Xiangya Hospital Central South University, Changsha, Hunan, China. [18]Department of Hematology/Oncology, Northwest Women's and Children's Hospital, Xi'an, China. [19]Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China.
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关键词: acute lymphocytic leukemia steroid response children overall survival event-free survival

摘要:
Whether steroid response is an independent risk factor for acute lymphoblastic leukemia (ALL) is controversial. This study aimed to investigate the relationship between response to dexamethasone and prognosis in children with ALL.We analyzed the data of 5,161 children with ALL who received treatment in accordance with the Chinese Children's Cancer Group ALL-2015 protocol between January 1, 2015, and December 31, 2018, in China. All patients received dexamethasone for 4 days as upfront window therapy. Based on the peripheral lymphoblast count on day 5, these patients were classified into the dexamethasone good response (DGR) and dexamethasone poor response (DPR) groups. A peripheral lymphoblast count ≥1× 109/L indicated poor response to dexamethasone.The age, white blood cell counts, prevalence of the BCR/ABL1 and TCF3/PBX1 fusion genes, and rates of recurrence in the central nervous system were higher in the DPR than in the DGR group (P<0.001). Compared to the DPR group, the DGR group had a lower recurrence rate (18.6% vs. 11%) and higher 6-year event-free survival (73% vs. 83%) and overall survival (86% vs. 92%) rates; nevertheless, subgroup analysis only showed significant difference in the intermediate-risk group (P<0.001).Response to dexamethasone was associated with an early treatment response in our study. In the intermediate-risk group, dexamethasone response added a prognostic value in addition to minimal residual disease, which may direct early intervention to reduce the relapse rate.Copyright © 2022 Chu, Cai, Cai, Bian, Cheng, Guan, Chen, Jiang, Zhai, Fang, Zhang, Tian, Zhou, Wang, Wang, Li, Kwan Alex, Yang, Yang, Zhan, Wang and Hu.

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大类 | 3 区 医学
小类 | 3 区 肿瘤学
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大类 | 3 区 医学
小类 | 3 区 肿瘤学
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Q2 ONCOLOGY
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Q2 ONCOLOGY

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第一作者机构: [1]Department of Hematology/Oncology, Pediatrics, the Second Hospital of Anhui Medical University, Hefei, China.
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