title: Prognostic impact of CD45 antigen expression in high-risk, childhood B-cell precursor acute lymphoblastic leukemia.
abstract: To evaluate the clinical implications of CD45 expression in acute childhood lymphoblastic leukemia (ALL), we measured the CD45 expression of blast cells from 133 untreated patients with childhood B-precursor ALL (n = 118) or T-ALL (n = 15). CD45 expression (> or = 20%) was detected in all 15 cases (100%) of T-ALL, and 101 cases (86%) of B-precursor ALL. In 122 cases, the fluorescence intensity of the CD45 expression was measured as a relative value; the ratio of average linear values (RALV) of CD45 on the blasts to that on CD3-positive T-lymphocytes from the same specimen. The expression was more intense in the T-ALL cases than in the B-precursor ALL cases (RALV, mean +/- SE: T-ALL 0.230 +/- 0.04 vs. pro-B ALL 0.150 +/- 0.012/pre-B ALL 0.153 +/- 0.019, p < 0.05). However, the intensity of the CD10, CD19, CD20 and CD34 antigen immunoreactivity did not correlate with the CD45 expression. Patients with hyperdiploidy (chromosome number > 50) showed significantly lower levels of CD45 expression than patients with t(1;19) or normal karyotypes (RALV, mean +/- SE: 0.081 +/- 0.022 vs. 0.133 +/- 0.03/0.143 +/- 0.019, p < 0.05). Other clinical features such as age, gender and WBC count did not correlate with CD45 expression. The prognostic implications of CD45 expression were studied in non-high-risk (low-risk + intermediate-risk) (n = 60) and high-risk patients (n = 52) with B-precursor ALL who had been treated with the risk-directed protocol of ALL-941 trial. Although CD45 expression did not correlate with the event-free survival (EFS) of the non-high-risk patients, there was a significant correlation between the expression levels and the EFS of the high-risk patients: the 3-year EFS rate of the CD45low group (n = 26, RALV = 0.017-0.132) was 88 +/- 7% versus the CD45high group (n = 26, RALV = 0.133-0.450) at 34 +/- 24% (p < 0.05). These results show that the levels of expression of the CD45 antigen on leukemic lymphoblasts are significantly correlated with the clinical features and prognosis of childhood ALL.
authors.affiliation: Department of Pediatrics, Aichi Medical University, Aichi, 480-1195 Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakamura
authors.forename: M
authors.initials: M
authors.lastname: Tsurusawa
authors.forename: A
authors.initials: A
authors.lastname: Kato
authors.forename: T
authors.initials: T
authors.lastname: Taga
authors.forename: Y
authors.initials: Y
authors.lastname: Hatae
authors.forename: M
authors.initials: M
authors.lastname: Miyake
authors.forename: J
authors.initials: J
authors.lastname: Mimaya
authors.forename: N
authors.initials: N
authors.lastname: Onodera
authors.forename: A
authors.initials: A
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: H
authors.initials: H
authors.lastname: Kanegane
authors.forename: T
authors.initials: T
authors.lastname: Matsushita
authors.forename: A
authors.initials: A
authors.lastname: Iwai
authors.forename: N
authors.initials: N
authors.lastname: Hyakuna
authors.forename: K
authors.initials: K
authors.lastname: Gushi
authors.forename: T
authors.initials: T
authors.lastname: Kawakami
authors.forename: I
authors.initials: I
authors.lastname: Sekine
authors.forename: O
authors.initials: O
authors.lastname: Izichi
authors.forename: K
authors.initials: K
authors.lastname: Asami
authors.forename: A
authors.initials: A
authors.lastname: Kikuta
authors.forename: A
authors.initials: A
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
mesh_terms: D015703:Antigens, CD / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage; D001402:B-Lymphocytes / Q000276:immunology*; D002648:Child; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D016130:Immunophenotyping; D017493:Leukocyte Common Antigens / Q000032:analysis*; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000276:immunology*; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D015703:Antigens, CD; D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone; D015122:Mercaptopurine; D017493:Leukocyte Common Antigens; D001215:Asparaginase; D008727:Methotrexate