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[Relationship between Early Treatment Response and Prognosis in Children with Acute Lymphoblastic Leukemia]

Yu Zheng1, Yun-Wang Cai2, Qi-Chang Fu1

  • 1Department of Pediatrics, Haikou Fourth People's Hospital, Haikou 571199, Hainan Province, China.

Zhongguo Shi Yan Xue Ye Xue Za Zhi
|June 29, 2018
PubMed

Insights

Early treatment response in children with acute lymphoblastic leukemia (ALL) significantly predicts prognosis. Good response to prednisone and low minimal residual disease levels indicate better event-free survival, highlighting their importance as prognostic factors.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Clinical Research

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
  • Predicting prognosis in pediatric ALL is crucial for tailoring treatment strategies.
  • Early indicators of treatment effectiveness can guide therapeutic adjustments.

Purpose of the Study:

  • To investigate the relationship between early treatment response and prognosis in children diagnosed with ALL.
  • To identify independent prognostic factors influencing event-free survival in pediatric ALL patients.

Main Methods:

  • A cohort of 278 children with ALL treated with the CCLg-ALL-2008 regimen was analyzed.
  • Early treatment response was assessed using sensitivity to prednisone at day 8 (D8-SRP), bone marrow remission at days 15 (D15-BMR) and 33 (D33-BMR), and minimal residual disease at day 33 (D33-MRD).
  • Cox regression analysis was employed to determine independent prognostic factors affecting 3-year event-free survival (EFS).

Main Results:

  • A significant difference in 3-year EFS was observed between prednisone good response (PGR) and poor response (PPR) groups (P<0.05).
  • Higher rates of bone marrow remission (M1) and lower levels of minimal residual disease (MRD < 10^-4) were associated with significantly better 3-year EFS rates (P<0.05).
  • Prednisone poor response, M2/M3 bone marrow remission, MRD ≥ 10^-2, and T-ALL typing were identified as independent risk factors for poor prognosis.

Conclusions:

  • Early treatment response, including D8-SRP, D15/D33-BMR, and D33-MRD, serves as a reliable predictor of prognosis in pediatric ALL.
  • These early response indicators are independent prognostic factors, valuable for risk stratification and treatment optimization in children with ALL.
Abstract

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