Prognostic significance of cell surface phenotype in acute lymphoblastic leukemia

To find out the phenotypic character of lymphoblasts of acute lymphoblastic leukemia (ALL) patients in our study cohort and their possible effect on the prognosis.

To investigate the phenotype in ALL in our demographic population and to prognosticate various upfront current protocols employed in our hospital.

The study spanned over a period of 4 years with retrospective and prospective data of January 2008 through December 2011.

159 patients of all age groups were enrolled for the study, of which flow cytometry was done in 144 patients.

Analysis was done using the variables on SPSS (statistical package for social sciences) software on computer. Survival curves were estimated by method of Kaplan-Meir.

Majority of the patients were of B-cell (68.1%) and 30.6% patients were of T-cell lineage. Of these, 80.6% patients were having cALLa positivity. Complete remission (CR) was achieved in 59.1%, 16.4% relapsed, and 20.1% patients died.

Phenotyping has become an important and integral part of diagnosis, classification, management and prognosticating in ALL. B-cell has been found to have a better survival over T-cell lymphoblastic leukemia. cALLa antigen positivity has good impact in achieving CR in only B-cell lineage, myeloid coexpression has no significant effect on the outcome. BFM (Berlin-Frankfurt-Münster) based protocols though showed a higher CR and survival vis-a-vis UKALL-XII. However, patients enrolled in former group being of low risk category and lesser in numbers cannot be compared statistically with a fair degree of confidence.