[Prognostic factors for childhood acute non-mature B-lymphoblastic leukemia].
OBJECTIVE
To study the prognostic factors for events-free survival (EFS) in children with acute non-mature B-lymphoblastic leukemia.


METHODS
One hundred and sixty-one children with newly diagnosed acute non-mature B-lymphoblastic leukemia received the ALL-XH-99 protocol treatment. Their medical data, including clinical, biological and molecule features, early responses to treatment (bone marrow evaluation on the 19th day of induction therapy), minimal residual disease (MRD) in bone marrow after remission induction therapy, the risk grade of disease before the beginning of chemotherapy and the outcome, were retrospectively studied.


RESULTS
Univariable analysis indicated that the gender and P170 levels before therapy had no effect on the outcome. Age, initial white blood cell count (WBC), prednisone response, early response to treatment, fusion genes (BCR/ABL or MLL/AF4) and MRD level were significantly related to the EFS (P<0.01). Immunophenotype, myeloid-associated antigen and the risk grade of disease were also related to the EFS (P<0.05). Multivariable analysis showed that WBC >or=50 x 10(9)/L, Cmu positive, BCR/ABL or MLL/AF4 positive and MRD positive (>or=0.01%) were risk factors for the poor prognosis (P<0.01). The early response to treatment was important to modify the therapy protocol.


CONCLUSIONS
WBC >or=50 x 10(9)/L, Cmu positive, BCR/ABL or MLL/AF4 positive and MRD positive have important prognostic values in childhood acute non-mature B-lymphoblastic leukemia. Early response to treatment is an important index for modifying the chemotherapy protocol.
Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. jiang_hua18@yahoo.com.cn
Hua
H
Jiang
Long-Jun
LJ
Gu
Hui-Liang
HL
Xue
Jing-Yan
JY
Tang
Jing
J
Chen
Ci
C
Pan
Jing
J
Chen
Chong
C
Xu
Lu
L
Dong
Min
M
Zhou
D000293:Adolescent; D002051:Burkitt Lymphoma / Q000188:drug therapy / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D016313:Genes, abl; D006801:Humans; D007223:Infant; D008297:Male; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics; D018365:Neoplasm, Residual; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D012044:Regression Analysis
C113855:MLL-AF4 fusion protein, human; D015514:Oncogene Proteins, Fusion; D051788:Myeloid-Lymphoid Leukemia Protein