Clinical significance of CD34 expression in childhood acute lymphoblastic leukemia.
Clinical significance of CD34 expression in childhood acute lymphoblastic leukemia.
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DOI：
10.1182/blood.v82.3.889.889
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发表时间：
1993-08
期刊：
影响因子：
20.3
通讯作者：
C. Pui;M. Hancock;D. Head;G. Rivera;A. Look;J. Sandlund;F. Behm
中科院分区：
文献类型：
--
作者：
C. Pui;M. Hancock;D. Head;G. Rivera;A. Look;J. Sandlund;F. Behm
在两次连续化疗的335例新诊断的儿童急性淋巴细胞白血病（ALL）中，235例（70%）原始细胞检测到≥ 10%的CD 34抗原。按免疫表型，阳性病例的分布有利于早期前B细胞ALL（83%; n = 180），其次是前B细胞ALL（61%; n = 89），然后是T细胞ALL（46%; n = 61）（P50染色体或DNA指数≥ 1.16）。CD 34+白血病患者的无事件生存率明显上级（P = 0.01），在诊断后5年，估计有83% +/- 6%（SE）的队列未发生不良事件，而无此特征的队列为63% +/- 10%。多变量分析表明，抗原的预后影响是独立的年龄，白细胞计数，和其他公认的因素，这表明它会增加目前的风险分配系统的判别力。T细胞ALL的结果相反：CD 34表达与初始CNS白血病和CD 10阴性呈正相关，但与任何良好的风险表现特征无关。对数秩分析表明，CD 34抗原表达对治疗结局无不良影响，但需要对其他患者进行研究以获得明确答案。B和T细胞系ALL中CD 34表达的相反临床相关性可能反映了这些白血病物种之间的基本生物学差异。
The CD34 antigen was detected on > or = 10% of the blast cells in 235 (70%) of 335 cases of newly diagnosed childhood acute lymphoblastic leukemia (ALL) treated in two consecutive chemotherapy trials. By immunophenotype, the distribution of positive cases favored early pre-B ALL (83%; n = 180) followed by pre-B ALL (61%; n = 89) and then T-cell ALL (46%; n = 61) (P 50 chromosomes or DNA index > or = 1.16). Event-free survival was clearly superior for patients with CD34+ leukemia (P = .01), with an estimated 83% +/- 6% (SE) of the cohort remaining free of adverse events at 5 years post diagnosis, as compared to 63% +/- 10% of the group without this feature. Multivariate analysis showed that the prognostic influence of the antigen was independent of age, leukocyte count, and other well-recognized factors, suggesting that it would add discriminatory power to current systems of risk assignment. Findings in T-cell ALL were the reverse: CD34 expression showed positive correlations with initial CNS leukemia and CD10 negativity but not with any good-risk presenting characteristics. Log-rank analysis indicated no adverse effect on treatment outcome by CD34 antigen expression, although additional patients with need to be studied to obtain a definitive answer. The opposed clinical associations of CD34 expression in B- and T-lineage ALL may reflect fundamental biologic differences between these leukemia species.