CXCR4 Overexpression is a Poor Prognostic Factor in Pediatric Acute Myeloid Leukemia With Low Risk: A Report From the Japanese Pediatric Leukemia/Lymphoma Study Group
CXCR4 Overexpression is a Poor Prognostic Factor in Pediatric Acute Myeloid Leukemia With Low Risk: A Report From the Japanese Pediatric Leukemia/Lymphoma Study Group
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DOI：
10.1002/pbc.26035
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发表时间：
2016-08-01
影响因子：
3.2
通讯作者：
Adachi, Souichi
中科院分区：
文献类型：
--
作者：
Matsuo, Hidemasa;Nakamura, Naomi;Adachi, Souichi
背景资料。CXC趋化因子受体4(CXCR4+)的过度表达是成人急性髓系白血病(AML)预后不良的因素，但其在儿童AML中的预后意义尚不清楚。程序。这项回顾性研究探讨了CXCR4+在日本儿童白血病/淋巴瘤研究组AML-05研究中登记的儿童AML患者的预后意义。结果。在总队列中(n=248)，CXCR4+患者(n=81)和CXCR4-患者(n=167)的3年总生存率(OS)差异无统计学意义(69.4%vs.75.2%，P=0.44)。然而，在低危组中，CXCR4+和CXCR4-患者的3年OS差异有统计学意义(n=93；79.2%vs.98.3%，P=0.007)。T(8；21)无KIT突变AML患者中CXCR4+患者的3年OS显著低于CXCR4-患者(n=44；76.1%vs.100.0%，P=0.01)。多因素COX回归分析显示，CXCR4+是LR AML患者OS的不良预后因素(风险比，11.47；P=0.01)。T(8；21)AML组CXCR4+患者的脾肿大发生率高于CXCR4-患者(25.9%vs.5.9%，P=0.03)。结论。这些结果表明，CXCR4+是LR患者，特别是无KIT突变的t(8；21)患者的不良预后因素。预后不良仅适用于OS，而不适用于无复发生存(RFS)，因此CXCR4+可能与复发后预后不良有关。强化治疗，包括给予CXCR4拮抗剂，对于患有LR的儿童AML患者可能是有希望的。(C)2016威利期刊公司。
Background. Overexpression of CXC chemokine receptor 4 (CXCR4+) is a poor prognostic factor in adult acute myeloid leukemia (AML); however, its prognostic significance in pediatric AML is unclear. Procedure. This retrospective study examined the prognostic significance of CXCR4+ in pediatric AML patients enrolled in the Japanese Pediatric Leukemia/Lymphoma Study Group AML-05 study. Results. In the total cohort (n = 248), no significant differences were observed between CXCR4+ patients (n = 81) and CXCR4-patients (n = 167) in terms of 3-year overall survival (OS) (69.4% vs. 75.2%, P = 0.44). However, there was a significant difference in 3-year OS between CXCR4+ and CXCR4-patients in the low-risk (LR) group (n = 93; 79.2% vs. 98.3%, P = 0.007). CXCR4+ patients in the t(8; 21) AML without KIT mutation group had a significantly worse 3-year OS than CXCR4-patients (n = 44; 76.1% vs. 100.0%, P = 0.01). Multivariate Cox regression analysis identified CXCR4+ as a poor prognostic factor for OS in LR AML patients (hazard ratio, 11.47; P = 0.01). Consistent with the data for survival analysis, CXCR4+ patients in the t(8; 21) AML group had a higher incidence of splenomegaly than CXCR4-patients (25.9% vs. 5.9%, P = 0.03). Conclusions. These results suggest that CXCR4+ is a poor prognostic factor for LR patients, particularly t(8; 21) patients without KIT mutation. The poor outcome was only applicable to OS, not relapse-free survival (RFS); thus, CXCR4+ may be associated with a poor prognosis after recurrence. Intensive therapy, including administration of CXCR4 antagonists, may be promising for pediatric AML patients with LR. (C) 2016 Wiley Periodicals, Inc.