title: [Prognostic Value of Prednisone Response in CCLG-ALL 2008].
abstract: OBJECTIVE
  To ovaluate the prognostic value of prednisone response in treatment regimes of children with acute lymphoblastic leukemia.
  
  
  METHODS
  A total of 598 newly diagnosed ALL patients were enrolled and received prednisone pre-treatment. Based on the peripheral lymphoblast count on day 8, these patients were divided into 2 groups: prednisone good response (PGR) and prednisone poor response (PPR). PPR patients were classified into high risk group immediately and then received intensed chemotherapy. The all enrolled patients were followed up and the clinical features and treatment outcomes of the two groups were analyzed.
  
  
  RESULTS
  Compared with PGR group, PPR group had different characteristics. They were older in age and had higher initial white blood cell count (P<0.05). T-cell ALL (T-ALL) and Philadelphia chromosome positive ALL (Ph+ ALL) were frequent in PPR group (P<0.05). Event-free survival (EFS) rate of PPR group was significantly lower than that of PGR group (P<0.05). 2 year event-free survival(EFS) rate of PGR group was (88.3±1.5)%, while the 2-year EFS rate of PPR group was (58.4±5.3)%. 5 year EFS rates of PGR and PPR were (80.8±2.1)% and (53.4±6.0)%, respectively. The EFS rate of PPR group was falling rapidly within 2 years. PPR group had higher relapse rate, and most relapses occurred within 18 months (P<0.05). PPR group had more high incidence of minimal residual disease (MRD) both on day 33 and on week 12 (P<0.05). No significant difference of EFS and relapse time was found between PPR and high risk PGR patients (P>0.05). In multi-variate regression analysis, the PPR, the presence of BCR-ABL1 and MLL were significantly unfavorable factors (P<0.05).
  
  
  CONCLUSIONS
  Prednisone response has been confirmed to be still great prognostic value and PPR children patients have poor outcomes generally. It is likely that the response to prednisone does not make much sense to high risk ALL patients.
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Ren
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Li-Xian
authors.initials: LX
authors.lastname: Chang
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: An
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Jing-Liao
authors.initials: JL
authors.lastname: Zhang
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China.
authors.forename: Tian-Feng
authors.initials: TF
authors.lastname: Liu
authors.affiliation: Institute of Hematology & Hospital of Blood Disease, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China. E-mail: xfzhu1981@126.com.
authors.forename: Xiao-Fan
authors.initials: XF
authors.lastname: Zhu
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D015999:Multivariate Analysis; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D011241:Prednisone; D011379:Prognosis; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D011241:Prednisone