title: Clinical relevance of CD10 expression in childhood ALL. The Italian Association for Pediatric Hematology and Oncology (AIEOP).
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  CD10 expression does not have independent prognostic significance in either the larger subgroup of B-ALL patients or in T-cell ALL.
authors.affiliation: Istituto di Clinica Pediatrica, Università di Pisa.
authors.forename: R
authors.initials: R
authors.lastname: Consolini
authors.forename: A
authors.initials: A
authors.lastname: Legitimo
authors.forename: R
authors.initials: R
authors.lastname: Rondelli
authors.forename: C
authors.initials: C
authors.lastname: Guguelmi
authors.forename: E
authors.initials: E
authors.lastname: Barisone
authors.forename: A
authors.initials: A
authors.lastname: Lippi
authors.forename: A
authors.initials: A
authors.lastname: Cantù-Rajnoldi
authors.forename: M
authors.initials: M
authors.lastname: Aricò
authors.forename: V
authors.initials: V
authors.lastname: Conter
authors.forename: M G
authors.initials: MG
authors.lastname: Cocito
authors.forename: M C
authors.initials: MC
authors.lastname: Putti
authors.forename: A
authors.initials: A
authors.lastname: Pession
authors.forename: G
authors.initials: G
authors.lastname: Masera
authors.forename: A
authors.initials: A
authors.lastname: Biondi
authors.forename: G
authors.initials: G
authors.lastname: Basso
mesh_terms: D000293:Adolescent; D000951:Antigens, Neoplasm / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007558:Italy / Q000453:epidemiology; D015448:Leukemia, B-Cell / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality; D015458:Leukemia, T-Cell / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality; D015993:Life Tables; D008297:Male; D014411:Neoplastic Stem Cells / Q000737:chemistry; D015260:Neprilysin / Q000032:analysis*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015260:Neprilysin