Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia.
The prognostic significance of CD20 expression in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has been mostly studied in children and yielded conflicting results. In 143 adults with Philadelphia chromosome-negative BCP-ALL treated in the multicentric GRAALL 2003 trial, CD20 positivity over 20% was observed in 32% of patients. While not influencing complete remission achievement, CD20 expression was associated with a higher cumulative incidence of relapse (CIR) at 42 months (P=0.04), independently of the ALL high-risk subset (P=0.025). Notably, the negative impact of CD20 expression on CIR was only observed in patients with a white blood cell count (WBC) over 30x10(9)/L (P=0.006), while not in those with a lower WBC. In the former subgroup, this impact translated into lower event-free survival (15% vs. 59% at 42 months, P=0.003). CD20 expression thus appears to be associated with a worse outcome, which reinforces the interest of evaluating rituximab combined to chemotherapy in CD20-positive adult BCP-ALL. ClinicalTrials.gov ID, NCT00222027.
Service d'Hématologie Clinique, CHU Henri Mondor, 51 av du Mal de Lattre de Tassigny, 94010 Créteil cedex, France. sebastien.maury@hmn.aphp.fr
Sébastien
S
Maury
Françoise
F
Huguet
Thibaut
T
Leguay
Francis
F
Lacombe
Marc
M
Maynadié
Sandrine
S
Girard
Adrienne
A
de Labarthe
Emilienne
E
Kuhlein
Emmanuel
E
Raffoux
Xavier
X
Thomas
Patrice
P
Chevallier
Agnès
A
Buzyn
André
A
Delannoy
Yves
Y
Chalandon
Jean-Paul
JP
Vernant
Philippe
P
Rousselot
Elizabeth
E
Macintyre
Norbert
N
Ifrah
Hervé
H
Dombret
Marie-Christine
MC
Béné
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D018951:Antigens, CD20 / Q000235:genetics*; D002986:Clinical Trials as Topic; D015870:Gene Expression; D006801:Humans; D007958:Leukocyte Count; D008875:Middle Aged; D010677:Philadelphia Chromosome; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000235:genetics* / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D055815:Young Adult
D018951:Antigens, CD20