Outcome and Clinical Significance of Immunophenotypic Markers Expressed in Different Treatment Protocols of Pediatric Patients With T-ALL in Developing Countries

Sayed, Douaa; Sayed, Heba; Raslan, Heba; Ali, Amany M.; Zahran, Asmaa M; Al-Hayek, Reema; Daama, Saad Al; Alsaber, Arwa

doi:10.1016/j.clml.2017.05.012

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…With intensive chemotherapy and allo-HSCT, the EFS rates for T-ALL have increased to 85% in developed countries[16,17], whereas the outcomes of T-ALL in developing counties have remained poor. The 3-year EFS rate for this study was 77.7±6.6%, which is similar to that in the literature [3]. The lower EFS rate in our study than that in developed countries may be partially due to the enrolled patients receiving a lower intensity of chemotherapy than the intensive protocols used for T-ALL patients in developed countries [16].…”

Section: Discussionsupporting

confidence: 85%

“…T cell acute lymphoblastic leukemia (T-ALL) accounts for approximately 15–20% of ALL in children [1]. Despite improvements in intensive chemotherapy and allogenic hematopoietic stem cell transplantation (allo-HSCT), 15–20% and 20–40% of pediatric T-ALL patients die of relapse or treatment failure in developed and developing countries, respectively [2,3]. The Cytokine receptor-like factor 2 ( CRLF2 ) gene encodes a member of the type I cytokine receptor family, and the encoded protein is a receptor for thymic stromal lymphopoietin ( TSLP ) [4].…”

Section: Introductionmentioning

confidence: 99%

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Clinical characterization and prognosis of T cell acute lymphoblastic leukemia with high CRLF2 gene expression in children

et al. 2019

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It has been reported that overexpression of the CRLF2 gene is associated with poor outcomes in pediatric B cell acute lymphoblastic leukemia (B-ALL), but the incidence rates, clinical characteristics and outcomes of CRLF2 gene overexpression in pediatric T cell ALL (T-ALL) have not been systematically analyzed. In this study, CRLF2 mRNA expression levels and clinical and laboratory parameters in 63 pediatric T-ALL patients were detected at the Children's Hospital of Chongqing Medical University and Children’s Hospital of Xianyang between February 2015 and June 2018. The patients were treated according to the modified St. Jude TXV ALL protocol, and early treatment responses (bone marrow smear and MRD level) and prognoses in the enrolled patients were assessed. CRLF2 overexpression was detected in 21/63 (33.33%) patients. Statistical differences were not found for clinical or laboratory parameters (including sex, age, initial WBC count, incidence mediastinal involvement, abnormal karyotype and fusion genes) between patients with high CRLF2 expression and patients with low expression of CRLF2 (P>0.05). One patient died of tumor lysis syndrome and renal failure, and the treatment response was monitored on day 19 (TP1) of remission in 62 patients. One patient quit treatment because of family decisions, and 61 patients underwent treatment response evaluation on day 46 (TP2) of remission. Significant differences were not found between patients with high CRLF2 expression and patients with low CRLF2 expression in terms of the treatment responses at TP1 or TP2 (P>0.05). Following October 2018, 12 patients among the 61 evaluable patients relapsed (relapse rate: 19.67%), 3 patients died from chemotherapy, and the treatment-related mortality (TRM) rate was 4.92%. Secondary tumors occurred in 1 patient. The 3-year prospective EFS rate was 54.1±11.2% and 77.7±6.6% for the 61 evaluable patients and 58 patients without TRM. Patients with low CRLF2 expression had longer EFS durations than patients with high CRLF2 expression (61 evaluable patients: 35.91± 2.38 months vs 23.43± 2.57 months; 58 patients without TRM: 37.86± 2.08 months vs 24.55±2.43 months, P<0.05). CRLF2 expression levels were also monitored in 13 patients at TP1 and TP2, and the MRD level did not vary with the CRLF2 expression level. Our data suggest that clinical features, laboratory findings and treatment responses in the pediatric T-ALL population do not vary based on the overexpression of CRLF2 but that CRLF2 overexpression can contribute to a high risk of relapse in pediatric T-ALL. Thus, CRLF2 expression levels should not be used as biomarkers for monitoring MRD.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Clinical characterization and prognosis of T cell acute lymphoblastic leukemia with high CRLF2 gene expression in children

et al. 2019

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“…(49,50) The frequency of negative CD10 in B-cell ALL cases was 8.3%, close to 11.36%, as reported by Haddad et al (11) In T-cell ALL, the most frequent aberrant markers were CD10 (44.3%), CD13 (36.5%), CD33 (25.4%) and CD117 (19%). Sayed et al, (51) in Egypt, found a frequency of 45.9% for CD10, 4.4% for CD13, 10.1% for CD33 and 5.1% for CD117. In India, Garg et al (52) reported a frequency of 35.3% for CD10, 38.46% for CD33 and 42.28% for CD117.…”

Section: ❚ Discussionmentioning

confidence: 95%

Immunophenotypic characterization of acute leukemias in Bahia, Brazil

Santos¹,

Santos²,

Santos³

et al. 2022

Einstein (São Paulo)

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“…A higher resistance rate was also observed in pediatric ETP-ALL [14,21,22]. However, a poor early response to standard treatment might be reverted by fine response-based risk stratification and subsequent therapy intensification, as the UK children's cooperative group showed [57,59]. The fairly good outcome of ETP-ALL patients in the UK study was partially attributed to the use of dexamethasone and pegylated asparaginase throughout the treatment.…”

Section: Treatment 251 Frontline Treatmentmentioning

confidence: 88%

Early T-Cell Precursor ALL and Beyond: Immature and Ambiguous Lineage T-ALL Subsets

Genescà

Starza

2022

Cancers

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A wide range of immature acute leukemias (AL), ranging from acute myeloid leukemias with minimal differentiation to acute leukemias with an ambiguous lineage, i.e., acute undifferentiated leukemias and mixed phenotype acute leukemia with T- or B-plus myeloid markers, cannot be definitely assigned to a single cell lineage. This somewhat “grey zone” of AL expresses partly overlapping features with the most immature forms of T-cell acute lymphoblastic leukemia (T-ALL), i.e., early T-cell precursor ALL (ETP-ALL), near-ETP-ALL, and pro-T ALL. These are troublesome cases in terms of precise diagnosis because of their similarities and overlapping phenotypic features. Moreover, it has become evident that they share several genomic alterations, raising the question of how their phenotypes reflect distinct AL entities. The aim of this review was to provide a systematic overview of the genetic events associated with immature T-ALL and outline their relationship with treatment choices and outcomes, especially looking at the most recent preclinical and clinical studies. We wish to offer a basis for using the genetic information for new diagnostic algorithms, in order to better stratify patients and improve their management with more efficient and personalized therapeutic options. Understanding the genetic profile of this high-risk T-ALL subset is a prerequisite for changing the current clinical scenario.

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Outcome and Clinical Significance of Immunophenotypic Markers Expressed in Different Treatment Protocols of Pediatric Patients With T-ALL in Developing Countries

Cited by 8 publications

References 26 publications

Clinical characterization and prognosis of T cell acute lymphoblastic leukemia with high CRLF2 gene expression in children

Clinical characterization and prognosis of T cell acute lymphoblastic leukemia with high CRLF2 gene expression in children

Immunophenotypic characterization of acute leukemias in Bahia, Brazil

Early T-Cell Precursor ALL and Beyond: Immature and Ambiguous Lineage T-ALL Subsets

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