Prognostic significance of steroid response in pediatric acute lymphoblastic leukemia: The CCCG-ALL-2015 study

作者全名："Chu, Jinhua; Cai, Huaju; Cai, Jiaoyang; Bian, Xinni; Cheng, Yumei; Guan, Xianmin; Chen, Xiaoqian; Jiang, Hua; Zhai, Xiaowen; Fang, Yongjun; Zhang, Lei; Tian, Xin; Zhou, Fen; Wang, Yaqin; Wang, Lingzhen; Li, Hong; Alex, Leung Wing Kwan; Yang, Minghua; Yang, Hanfang; Zhan, Aijun; Wang, Ningling; Hu, Shaoyan"

作者地址："[Chu, Jinhua; Cai, Huaju; Wang, Ningling] Anhui Med Univ, Hosp 2, Dept Hematol Oncol, Pediat, Hefei, Peoples R China; [Cai, Jiaoyang] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Dept Hematol Oncol, Sch Med, Shanghai, Peoples R China; [Bian, Xinni; Hu, Shaoyan] Soochow Univ, Dept Hematol Oncol, Childrens Hosp, Suzhou, Peoples R China; [Cheng, Yumei] Chinese Acad Med Sci & Peking Union Med Coll, Inst Hematol, Dept Pediat, Tianjin, Peoples R China; [Cheng, Yumei] Chinese Acad Med Sci & Peking Union Med Coll, Blood Dis Hosp, Tianjin, Peoples R China; [Guan, Xianmin] Chongqing Med Univ, Dept Hematol Oncol, Childrens Hosp, Chongqing, Peoples R China; [Chen, Xiaoqian] Sichuan Univ, West China Hosp 2, Hematol Oncol, Chengdu, Peoples R China; [Jiang, Hua] Guangzhou Women & Children Hlth Care Ctr, Dept Hematol Oncol, Guangzhou, Peoples R China; [Zhai, Xiaowen] Fudan Univ, Dept Hematol Oncol, Childrens Hosp, Shanghai, Peoples R China; [Fang, Yongjun] Nanjing Med Univ, Nanjing Childrens Hosp, Dept Hematol Oncol, Nanjing, Peoples R China; [Zhang, Lei] Southern Med Univ, Nanfang Hosp, Dept Pediat, Guangzhou, Peoples R China; [Tian, Xin] Kunming Childrens Hosp, Dept Hematol Oncol, Kunming, Peoples R China; [Zhou, Fen] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Pediat, Union Hosp, Wuhan, Peoples R China; [Wang, Yaqin] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Pediat, Wuhan, Peoples R China; [Wang, Lingzhen] Qingdao Univ, Affiliated Hosp, Dept Pediat, Qingdao, Peoples R China; [Li, Hong] Shanghai Jiao Tong Univ, Childrens Hosp, Dept Hematol Oncol, Shanghai, Peoples R China; [Alex, Leung Wing Kwan] Chinese Univ Hong Kong, Hong Kong Childrens Hosp, Dept Pediat, Hong Kong, Peoples R China; [Yang, Minghua] Cent South Univ, Dept Pediat, Xiangya Hosp, Changsha, Hunan, Peoples R China; [Yang, Hanfang] Northwest Womens & Childrens Hosp, Dept Hematol Oncol, Xian, Peoples R China"

通信作者："Wang, NL (通讯作者)，Anhui Med Univ, Hosp 2, Dept Hematol Oncol, Pediat, Hefei, Peoples R China.; Hu, SY (通讯作者)，Soochow Univ, Dept Hematol Oncol, Childrens Hosp, Suzhou, Peoples R China."

来源：FRONTIERS IN ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000908072900001

JCR分区：Q2

影响因子：4.7

年份：2022

卷号：12

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：acute lymphocytic leukemia; steroid response; children; overall survival; event-free survival

摘要："IntroductionWhether steroid response is an independent risk factor for acute lymphoblastic leukemia (ALL) is controversial. This study aimed to investigate the relationship between response to dexamethasone and prognosis in children with ALL. MethodsWe analyzed the data of 5,161 children with ALL who received treatment in accordance with the Chinese Children's Cancer Group ALL-2015 protocol between January 1, 2015, and December 31, 2018, in China. All patients received dexamethasone for 4 days as upfront window therapy. Based on the peripheral lymphoblast count on day 5, these patients were classified into the dexamethasone good response (DGR) and dexamethasone poor response (DPR) groups. A peripheral lymphoblast count >= 1x 10(9)/L indicated poor response to dexamethasone. ResultsThe age, white blood cell counts, prevalence of the BCR/ABL1 and TCF3/PBX1 fusion genes, and rates of recurrence in the central nervous system were higher in the DPR than in the DGR group (P<0.001). Compared to the DPR group, the DGR group had a lower recurrence rate (18.6% vs. 11%) and higher 6-year event-free survival (73% vs. 83%) and overall survival (86% vs. 92%) rates; nevertheless, subgroup analysis only showed significant difference in the intermediate-risk group (P<0.001). DiscussionResponse to dexamethasone was associated with an early treatment response in our study. In the intermediate-risk group, dexamethasone response added a prognostic value in addition to minimal residual disease, which may direct early intervention to reduce the relapse rate."

基金机构：　

基金资助正文：