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Treatment response and outcome of children with T-cell acute lymphoblastic leukemia expressing the gamma-delta T-cell

Ching-Hon Pui1,2,3, Deqing Pei4, Cheng Cheng4

  • 1Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Oncoimmunology
|August 16, 2019
PubMed

Insights

Pediatric T-cell acute lymphoblastic leukemia (T-ALL) expressing the gamma delta T-cell receptor (γδ TCR) shows a poorer response to treatment and decreased survival rates compared to other T-ALL patients, despite risk-directed therapy.

Area of Science:

  • Oncology
  • Immunology
  • Pediatric Hematology

Background:

  • Gamma delta T-cell receptor (γδ TCR) expressing T-cell malignancies are linked to poor prognoses.
  • Understanding the clinical outcomes of pediatric T-cell acute lymphoblastic leukemia (T-ALL) with γδ TCR expression is crucial for treatment stratification.

Purpose of the Study:

  • To determine the clinical outcome of pediatric patients with T-cell acute lymphoblastic leukemia (T-ALL) expressing the γδ T-cell receptor (TCR).

Main Methods:

  • Analysis of γδ TCR repertoire in 93 newly diagnosed pediatric T-ALL patients using paired sequencing.
  • Evaluation of minimal residual disease (MRD) at specific time points during remission induction.
  • Comparison of clinical outcomes, including survival rates, between γδ T-ALL and other T-ALL patient groups.

Main Results:

  • 13% of pediatric T-ALL patients expressed γδ TCR.
  • γδ T-ALL patients showed significantly higher rates of MRD ≥ 1% on day 15-19 (67% vs. 33%) and day 42-49 (33% vs. 7%) compared to other T-ALL patients.
  • The 10-year overall survival for γδ T-ALL patients (66.7%) was significantly lower than for other T-ALL patients (93.3%).

Conclusions:

  • Pediatric γδ T-ALL is associated with a poor response to remission induction therapy, indicated by higher MRD levels.
  • Children with γδ T-ALL exhibit decreased survival rates compared to other T-ALL patients, even with risk-directed therapy.
  • The findings suggest a need for tailored therapeutic strategies for pediatric γδ T-ALL.

Keywords:
HCTTCR repertoirepediatric T-ALLrisk stratificationγδ T cellsγδ T-ALL

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