[Prognostic factors in children with acute T-lymphoblastic leukemia: a single-center clinical study of the CCCG-ALL-2015 protocol]
1Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
Insights
Minimal residual disease (MRD) is a key predictor of outcomes in pediatric T-acute lymphoblastic leukemia (T-ALL). Monitoring MRD levels helps personalize treatment and improve survival rates for these young patients.
Area of Science:
- Pediatric Hematology Oncology
- Leukemia Research
- Clinical Trial Analysis
Context:
- Acute T-lymphoblastic leukemia (T-ALL) is a significant pediatric cancer.
- Effective prognostic markers are crucial for optimizing treatment strategies.
- The CCCG-ALL-2015 protocol provides a standardized treatment approach.
Purpose:
- To investigate the clinical features of pediatric T-ALL.
- To identify prognostic factors influencing survival in T-ALL patients.
- To analyze the relationship between minimal residual disease (MRD) and patient outcomes.
Summary:
- A retrospective analysis of 50 children with T-ALL treated under the CCCG-ALL-2015 protocol was performed.
- Minimal residual disease (MRD) positivity on day 46 post-induction remission therapy was significantly associated with relapse.
- MRD levels on day 46 were identified as an independent prognostic factor for T-ALL patients.
Impact:
- Early detection of MRD can guide personalized treatment adjustments.
- Improved prognostic accuracy can lead to better survival outcomes for children with T-ALL.
- This study highlights the critical role of MRD monitoring in managing pediatric T-ALL.
Objectives:
To explore the clinical characteristics of children with acute T-lymphoblastic leukemia (T-ALL) and analyze their relationship with prognosis.
Methods:
A retrospective analysis was conducted on the clinical data and follow-up results of 50 children with T-ALL who were treated using the CCCG-ALL-2015 protocol at the Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University from November 2015 to December 2019. Kaplan-Meier survival analysis and Cox regression analysis were employed to identify factors affecting prognosis.
Results:
Among the 50 T-ALL patients, there were 7 cases of relapse. There was no statistically significant difference in the baseline clinical data between the relapse group and the non-relapse group (P>0.05). However, the positive rate of minimal residual disease (MRD) (≥0.01%) on day 46 after induction remission therapy in the relapse group was significantly higher than that in the non-relapse group (P=0.037). The 5-year overall survival rate for the 50 patients was (87±5)%, and the 5-year event-free survival rate was (86±5)%. Multivariate Cox regression analysis indicated that the MRD level on day 46 after induction remission therapy was an independent prognostic factor (HR=0.104, 95%CI: 0.015-0.740, P=0.024).
Conclusions:
MRD is of significant importance for the prognosis of T-ALL children. Personalized treatment should be provided based on MRD levels to prevent relapse and improve prognosis in these patients.
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