Clinical significance of immunophenotypic markers in pediatric T-cell acute lymphoblastic leukemia.
BACKGROUND
Cell-marker profiling has led to conflicting conclusions about its prognostic significance in T-ALL.


OBJECTIVE
To investigate the prevalence of the expression of CD34, CD10 and myeloid associated antigens (CD13/ CD33) in childhood T-ALL and to relate their presence to initial clinical and biologic features and early response to therapy.


METHODS
This study included 67 consecutive patients with newly diagnosed T-ALL recruited from the Children's Cancer Hospital in Egypt during the time period from July 2007 to June 2008. Immunophenotypic markers and minimal residual disease (MRD) were studied by five-color flow cytometry.


RESULTS
The frequency of CD34 was 34.9% , CD10 33.3% , while CD13/CD33 was 18.8%. No significant association was encountered between CD34, CD10 or myeloid antigen positivity and the presenting clinical features as age, sex, TLC and CNS leukemia. Only CD10(+) expression had significant association with initial CNS involvement (p=0.039). CD34 and CD13/CD33 expression was significantly associated with T-cell maturation stages (p<0.05). No relationship was observed for age, TLC, gender, NCI risk or CNS involvement with early response to therapy illustrated by BM as well as MRD day 15 and day 42. CD34(+), CD13/CD33(+) and early T-cell stage had high MRD levels on day 15 that was statistically highly significant (p<0.01), but CD10(+) had statistically significant lower MRD level on day 15 (p=0.049). However, only CD34 retained its significance at an MRD cut-off level of 0.01%.


CONCLUSIONS
CD34, CD10, CD13/CD33 expression, as well as T-cell maturation stages, may have prognostic significance in pediatric T-ALL as they have a significant impact on early clearance of leukemic cells detected by MRD day 15.
Sidhom
Iman
I
The Department of Pediatric Oncology, National Cancer Institute, Cairo, Egypt. ImanSidhom@yahoo.com
Shaaban
Khaled
K
Soliman
Sonya
S
Ezzat
Sameera
S
El-Anwar
Wafaa
W
Hamdy
Nayera
N
Yassin
Dina
D
Salem
Sherine
S
Hassanein
Hala
H
Mansour
Mohamed Tarek
MT
D000293:Adolescent; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018826:CD13 Antigens / Q000378:metabolism; D002454:Cell Differentiation; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D008297:Male; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D015260:Neprilysin / Q000378:metabolism; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D011379:Prognosis; D012074:Remission Induction; D063268:Sialic Acid Binding Ig-like Lectin 3; D016896:Treatment Outcome
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; D014408:Biomarkers, Tumor; C571163:CD33 protein, human; D063268:Sialic Acid Binding Ig-like Lectin 3; D018826:CD13 Antigens; D015260:Neprilysin