Clinical features, early treatment responses, and outcomes of pediatric acute lymphoblastic leukemia in china with or without specific fusion transcripts: A single institutional study of 1,004 patients

Abstract

Acute lymphoblastic leukemia (ALL) with distinct fusion transcripts has unique clinical features. In this study, the incidence, clinical characteristics, early treatment response, and outcomes of 1,004 Chinese pediatric ALLs were analyzed. Patients with TEL‐AML1 and E2A‐PBX1 fusion genes or other B cell precursor ALLs (BCP‐ALL) had favorable clinical features, were sensitive to prednisone, had low minimal residual disease (MRD), and an excellent prognosis, with a 5‐year event‐free survival (EFS) of 84–92%. T‐ALL was associated with a high WBC, increased age, more central nervous system involvement, a poor prednisone response, and high MRD, with a 5‐year EFS of 68.4 ± 5.2%. Patients with BCR‐ABL and MLL rearrangements usually had adverse clinical presentations and treatment responses, and a dismal prognosis, with 5‐year EFS of 27.3 and 57.4%, respectively. We also showed that BCR‐ABL and MLL rearrangements, the prednisone response, and MRD were independent prognostic factors. Interestingly, the BCH‐2003 protocol resulted in a better outcome for E2A‐PBX1+ patients than the CCLG‐2008 protocol. Intermediate and late relapses were more common in TEL‐AML1+ patients and other BCP‐ALLs compared with other subgroups (P = 0.018). Therefore, this study suggests that a fusion gene‐specific chemotherapy regimen and/or targeted therapy should be developed to improve further the cure rate of pediatric ALL. Am. J. Hematol. 2012. © 2012 Wiley Periodicals, Inc.

Clinical characteristics of acute lymphoblastic leukemia in male and female patients: A retrospective analysis of 705 patients

“…However, controversy remains over the effect of seasonal factors in the incidence, diagnosis and treatment of ALL (7,24,29). Gao et al (12) performed an international survey in Singapore, the USA and Sweden to provide evidence for the seasonal diagnosis of ALL. It was concluded that little evidence exsisted for a seasonal influence on ALL diagnosis.…”

“…The majority of previous studies on Chinese patients conveyed limited data regarding gender difference (4,(8)(9)(10)(11). In addition, the patients in these studies were from Northern China, such as Beijing (12), Eastern China, such as Shanghai (5,6,(9)(10)(11), and central China, such as Wuhan (10). To the best of our knowledge, only one study has reported the characteristics of ALL patients between 1985 and 1994 in Southern China, in Hong Kong (3).…”

Whole-transcriptome sequencing identifies a distinct subtype of acute lymphoblastic leukemia with predominant genomic abnormalities of EP300 and CREBBP

“…Subjects were selected based on sample availability. To test the frequency of EP300-ZNF384 and CREBBP-ZNF384 fusions, 602 children with newly diagnosed ALL from Beijing Children's Hospital, China (Gao et al 2012), were included as the validation cohort (239 cases with BCR-ABL1, ETV6-RUNX1, TCF3-PBX1, TCF3-HLF, or MLL rearrangements). Total RNA and genomic DNA were extracted from diagnostic bone marrow.…”

Children Diagnosed as Mixed-Phenotype Acute Leukemia Didn’t Benefit from the CCLG-2008 Protocol, Retrospective Analysis from Single Center

“…There was no case with LR. All the patients were treated by the risk-based strategy therapy of CCLG-2008 protocol (SF), in which bone marrow transplantation (BMT) was an optional therapy for those patients who didn't respond well to chemotherapy [9].…”