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Prognostic implications of CD9 in childhood acute lymphoblastic leukemia: insights from a nationwide multicenter study in China

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机构: [1]Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong. [2]Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong. [3]Department of Hematology/Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, National Health Committee Key Laboratory of Pediatric Hematology & Oncology, Shanghai, China. [4]Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, National Health Committee Key Laboratory of Pediatric Hematology & Oncology, Shanghai, China. [5]Department of Hematology/Oncology, Shanghai Children's Hospital, Shanghai, China. [6]Department of Pediatrics, Xiangya Hospital Central South University, Changsha, China. [7]Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [8]Department of Hematology/Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China. [9]Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China. [10]Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, Chengdu, China. [11]Department of Hematology/Oncology, Children's Hospital of Fudan University, Shanghai, China. [12]Department of Pediatrics, Anhui Medical University Second Affiliated Hospital, Anhui, China. [13]Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China. [14]Department of Hematology/Oncology, KunMing Children's Hospital, Kunming, China. [15]Department of Hematology/Oncology, Jiangxi Provincial Children's Hospital, Nanchang, China. [16]Department of Hematology/Oncology, Xi 'an Northwest Women's and Children's Hospital, Xi 'an, China. [17]Department of Hematology/Oncology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China. [18]Department of Pediatrics, Affiliated Hospital of Qingdao University, Qingdao, China. [19]Department of Pediatrics, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China. [20]Department of Hematology/Oncology, Children's Hospital of Soochow University, Suzhou, China. [21]Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China. [22]Department of Pediatrics, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [23]Departments of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA. [24]Department of Hematology/Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, National Health Committee Key Laboratory of Pediatric Hematology & Oncology, Shanghai, China. [25]Departments of Oncology, Pathology, and Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA. [26]Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong. [27]Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong.
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The outcomes of children with acute lymphoblastic leukemia (ALL) have been incrementally improved with risk-directed chemotherapy but therapy responses remain heterogeneous. Parameters with added prognostic values are warranted to refine the current risk stratification system and inform appropriate therapies. CD9, implicated by our prior single-center study, holds promise as one such parameter. To determine its precise prognostic significance, we analyzed a nationwide, multicenter, uniformly treated cohort of childhood ALL cases, where CD9 status was defined by flow cytometry on diagnostic samples of 3781 subjects. CD9 was expressed in 88.5% of B-ALL and 27.9% of T-ALL cases. It conferred a lower 5-year EFS and a higher CIR in B-ALL but not in T-ALL patients. The prognostic impact of CD9 was most pronounced in the intermediate/high-risk arms and those with minimal residual diseases, particularly at day 19 of remission induction. The adverse impact of CD9 was confined to specific cytogenetics, notably BCR::ABL1+ rather than KMT2A-rearranged leukemia. Multivariate analyses confirmed CD9 as an independent predictor of both events and relapse. The measurement of CD9 offers insights into patients necessitating intervention, warranting its seamless integration into the diagnostic marker panel to inform risk level and timely introduction of therapeutic intervention for childhood ALL.© 2023. The Author(s).

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大类 | 1 区 医学
小类 | 1 区 血液学 1 区 肿瘤学
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大类 | 1 区 医学
小类 | 1 区 血液学 1 区 肿瘤学
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Q1 HEMATOLOGY Q1 ONCOLOGY
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Q1 HEMATOLOGY Q1 ONCOLOGY

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第一作者机构: [1]Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong. [2]Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong.
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通讯机构: [26]Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong. [27]Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong.
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