title: Allogeneic hematopoietic stem cell transplantation overcomes the adverse prognostic impact of CD20 expression in acute lymphoblastic leukemia.
abstract: CD20 expression is associated with early recurrence and inferior survival in precursor-B acute lymphoblastic leukemia patients treated with chemotherapy. Whether CD20 influences outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is unknown. We analyzed CD20 expression on blasts at diagnosis in 157 patients who underwent allo-HSCT in the first complete remission (57%) or the second complete remission (43%). Of 125 evaluable patients, 71 were ≥ 20 years of age. CD20 expression was observed in 58 patients (46%; 52% of children, 39% of adults). There was no association between age, Ph(+) status, white blood cell count at diagnosis, and CD20 positivity. After allo-HSCT, disease-free survival at 5 years was 48% for all patients, 55% (95% confidence interval 40%-67%) for CD20(+) patients, and 43% (95% confidence interval 30%-54%) for CD20(-) patients (P = .15). Relapse did not differ between the groups. These results can serve as a reference to evaluate incorporation of anti-CD20 therapeutics to HSCT for the CD20(+) acute lymphoblastic leukemia subset. Clinical trial numbers for www.clinicaltrials.gov are NCT00365287, NCT00305682, and NCT00303719.
authors.affiliation: Blood and Marrow, Transplant Program, University of Minnesota, Minneapolis, MN, USA. bach0173@umn.edu
authors.forename: Veronika
authors.initials: V
authors.lastname: Bachanova
authors.forename: Karamjeet
authors.initials: K
authors.lastname: Sandhu
authors.forename: Sophia
authors.initials: S
authors.lastname: Yohe
authors.forename: Qing
authors.initials: Q
authors.lastname: Cao
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Burke
authors.forename: Michael R
authors.initials: MR
authors.lastname: Verneris
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018951:Antigens, CD20 / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000378:metabolism / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018951:Antigens, CD20; D014408:Biomarkers, Tumor