Clinical characteristics and prognosis of pediatric patients with B cell acute lymphoblastic leukemia relapse

Zhang,Xiaohong; Wu,Haixia; Fan,Hong; Su,Baifang; Zhang,Ge; Dong,Lin

doi:10.3892/ol.2018.8974

Clinical characteristics and prognosis of pediatric patients with B cell acute lymphoblastic leukemia relapse

Authors:
- Xiaohong Zhang
- Haixia Wu
- Hong Fan
- Baifang Su
- Ge Zhang
- Lin Dong
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Affiliations: Department of Pediatrics, Jining First People's Hospital, Jining, Shandong 272000, P.R. China, Department of Pediatrics, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China, Department of Nursing, People's Hospital of Zhangqiu District, Jinan, Shandong 250000, P.R. China, Department of Science and Education, People's Hospital of Zhangqiu District, Jinan, Shandong 250000, P.R. China, Department of Obstetrics, People's Hospital of Zhangqiu District, Jinan, Shandong 250000, P.R. China, Department of Hematology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250000, P.R. China
Published online on: June 18, 2018 https://doi.org/10.3892/ol.2018.8974
Pages: 2929-2934
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate the clinical characteristics and prognosis of pediatric patients with B cell acute lymphoblastic leukemia (B-ALL) relapse. A total of 390 pediatric patients diagnosed as B-ALL and receiving regular chemotherapy in Jining First People's Hospital from August 2010 to May 2016 were selected. The clinical characteristics, therapeutic response and prognosis were compared between the two groups. There were significant differences in the comparisons of age, leukocyte count in the initial diagnosis and glucocorticoid sensitive test between B-cell ALL (B-ALL) relapse group and non-relapse group; the minimal residual disease (MRD) levels of pediatric patients in the two groups at 33 days and 12 weeks were significantly different. The 3-year event-free survival (EFS) rates of pediatric patients with early, medium and late B-ALL relapse were 12.5±7.8%, 33.1±9.8% and 63.6±6.1%, respectively, and the prognosis of late relapse was significantly better than that of early relapse (P<0.001). The 3-year EFS rates of pediatric patients with bone marrow relapse in standard risk group, intermediate risk group and high risk group were 29.1±6.9, 31.3±6.5 and 28.3±6.3%, respectively; there were no statistically significant differences (P=0.387, P>0.05). Pediatric patients with B-ALL relapse are characterized by higher onset age (≥10 years old), high leukocyte count and hormone insensitivity. Dynamic monitoring of MRD level in B-ALL pediatric patients can predict the relapse.

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1	Hunger SP and Mullighan CG: Acute lymphoblastic leukemia in children. N Engl J Med. 373:1541–1552. 2015. View Article : Google Scholar : PubMed/NCBI
2	Roy A, Cargill A, Love S, Moorman AV, Stoneham S, Lim A, Darbyshire PJ, Lancaster D, Hann I, Eden T, et al: Outcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial. Br J Haematol. 130:67–75. 2005. View Article : Google Scholar : PubMed/NCBI
3	Locatelli F, Schrappe M, Bernardo ME and Rutella S: How I treat relapsed childhood acute lymphoblastic leukemia. Blood. 120:2807–2816. 2012. View Article : Google Scholar : PubMed/NCBI
4	Raetz EA, Borowitz MJ, Devidas M, Linda SB, Hunger SP, Winick NJ, Camitta BM, Gaynon PS and Carroll WL: Reinduction platform for children with first marrow relapse of acute lymphoblastic Leukemia: A Children's Oncology Group Study. J Clin Oncol. 26:3971–3978. 2008. View Article : Google Scholar : PubMed/NCBI
5	Nguyen K, Devidas M, Cheng SC, La M, Raetz EA, Carroll WL, Winick NJ, Hunger SP, Gaynon PS and Loh ML: Children's Oncology Group: Factors influencing survival after relapse from acute lymphoblastic leukemia: A Children's Oncology Group study. Leukemia. 22:2142–2150. 2008. View Article : Google Scholar : PubMed/NCBI
6	Einsiedel HG, von Stackelberg A, Hartmann R, Fengler R, Schrappe M, Janka-Schaub G, Mann G, Hählen K, Göbel U, Klingebiel T, et al: Long-term outcome in children with relapsed ALL by risk-stratified salvage therapy: Results of trial acute lymphoblastic leukemia-relapse study of the Berlin-Frankfurt-Münster Group 87. J Clin Oncol. 23:7942–7950. 2005. View Article : Google Scholar : PubMed/NCBI
7	Lawson SE, Harrison G, Richards S, Oakhill A, Stevens R, Eden OB and Darbyshire PJ: The UK experience in treating relapsed childhood acute lymphoblastic leukaemia: A report on the medical research council UKALLR1 study. Br J Haematol. 108:531–543. 2000. View Article : Google Scholar : PubMed/NCBI
8	Bailey LC, Lange BJ, Rheingold SR and Bunin NJ: Bone-marrow relapse in paediatric acute lymphoblastic leukaemia. Lancet Oncol. 9:873–883. 2008. View Article : Google Scholar : PubMed/NCBI
9	Hogan LE, Meyer JA, Yang J, Wang J, Wong N, Yang W, Condos G, Hunger SP, Raetz E, Saffery R, et al: Integrated genomic analysis of relapsed childhood acute lymphoblastic leukemia reveals therapeutic strategies. Blood. 118:5218–5226. 2011. View Article : Google Scholar : PubMed/NCBI
10	Pieters R, den Boer ML, Durian M, Janka G, Schmiegelow K, Kaspers GJ, van Wering ER and Veerman AJ: Relation between age, immunophenotype and in vitro drug resistance in 395 children with acute lymphoblastic leukemia - implications for treatment of infants. Leukemia. 12:1344–1348. 1998. View Article : Google Scholar : PubMed/NCBI
11	Borowitz MJ, Devidas M, Hunger SP, Bowman WP, Carroll AJ, Carroll WL, Linda S, Martin PL, Pullen DJ, Viswanatha D, et al: Children's Oncology Group: Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: A Children's Oncology Group study. Blood. 111:5477–5485. 2008. View Article : Google Scholar : PubMed/NCBI
12	Zhang R, Yang JY, Sun HQ, Jia H, Liao J, Shi YJ and Li G: Comparison of minimal residual disease (MRD) monitoring by WT1 quantification between childhood acute myeloid leukemia and acute lymphoblastic leukemia. Eur Rev Med Pharmacol Sci. 19:2679–2688. 2015.PubMed/NCBI
13	Möricke A, Reiter A, Zimmermann M, Gadner H, Stanulla M, Dördelmann M, Löning L, Beier R, Ludwig WD, Ratei R, et al: German-Austrian-Swiss ALL-BFM Study Group: Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: Treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95. Blood. 111:4477–4489. 2008. View Article : Google Scholar : PubMed/NCBI
14	No authors listed: An International System for Human Cytogenetic Nomenclature (1985) ISCN 1985. Report of the Standing Committee on Human Cytogenetic Nomenclature. Birth Defects Orig Artic Ser. 21:1–117. 1985.
15	Parker C, Waters R, Leighton C, Hancock J, Sutton R, Moorman AV, Ancliff P, Morgan M, Masurekar A, Goulden N, et al: Effect of mitoxantrone on outcome of children with first relapse of acute lymphoblastic leukaemia (ALL R3): An open-label randomised trial. Lancet. 376:2009–2017. 2010. View Article : Google Scholar : PubMed/NCBI
16	Gao YJ, Zhu XH, Yang Y, Wu Y, Lu FJ, Zhai XW and Wang HS: Prevalence of ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia in China. Cancer Genet Cytogenet. 178:57–60. 2007. View Article : Google Scholar : PubMed/NCBI
17	Mariottini P and Amaldi F: The 5′ untranslated region of mRNA for ribosomal protein S19 is involved in its translational regulation during Xenopus development. Mol Cell Biol. 10:816–822. 1990. View Article : Google Scholar : PubMed/NCBI
18	Pui CH, Carroll WL, Meshinchi S and Arceci RJ: Biology, risk stratification, and therapy of pediatric acute leukemias: An update. J Clin Oncol. 29:551–565. 2011. View Article : Google Scholar : PubMed/NCBI
19	Gorman MF, Ji L, Ko RH, Barnette P, Bostrom B, Hutchinson R, Raetz E, Seibel NL, Twist CJ, Eckroth E, et al: Outcome for children treated for relapsed or refractory acute myelogenous leukemia (rAML): A Therapeutic Advances in Childhood Leukemia (TACL) Consortium study. Pediatr Blood Cancer. 55:421–429. 2010. View Article : Google Scholar : PubMed/NCBI
20	van den Berg H, de Groot-Kruseman HA, Damen-Korbijn CM, de Bont ES, Schouten-van Meeteren AY and Hoogerbrugge PM: Outcome after first relapse in children with acute lymphoblastic leukemia: A report based on the Dutch Childhood Oncology Group (DCOG) relapse all 98 protocol. Pediatr Blood Cancer. 57:210–216. 2011. View Article : Google Scholar : PubMed/NCBI
21	Gaynon PS: Childhood acute lymphoblastic leukaemia and relapse. Br J Haematol. 131:579–587. 2005. View Article : Google Scholar : PubMed/NCBI
22	von Stackelberg A, Seeger K, Henze G and Eckert C: Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia. 18:1727–1729. 2004. View Article : Google Scholar : PubMed/NCBI