Correlation analysis of positive myeloid antigen and clinical feature of children with acute lymphoblastic leukemia / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the correlation of the myeloid antigen expression and clinical characteristics of acute lymphoblastic leukemia (ALL) in children.Methods The clinical data of 77 newly diagnosed ALL patients in Department of Hematology,the People's Hospital of Zhengzhou University from Jan.2010 to Dec.2013 were analyzed.The patients included 53 boys and 24 girls with a median age of 7.73 (2.00-15.00) years old.Based on flow cytometry (FCM) analysis of bone marrow,these patients were divided into 2 groupsone group included 26 patients with positive myeloid antigen expression (MyAg + ALL) and the other group included 51 patients with negative myeloid antigen expressions (MyAg-ALL).The correlation among myeloid antigen expression,clinical features,prednisone experiment,myelogram on the 15th day was analyzed through induction chemotherapy and minimal residual disease (MRD) on the 33rd day,and the rate of disease-free survival (DFS) was compared between the 2 groups.Results There were 26 cases with myeloid antigen expression among 77 patients (33.77％),CD13 + accounting for 19.48％ (15/77 cases),CD33 + 10.39％ (8/77 cases),and CD117 + 5.19％ (4/77 cases).Among these patients,there were 2 patients expressing both CD13 + and CD33 +,and 1 patient expressing both CD33 + and CD117 +.There was no difference between the MyAg + ALL group and MyAg-ALL group in gender (x2 =0.217,P =0.641),age (≥ 10 years old,x2 =0.011,P =0.918),white blood count(≥50 × 109/L,x2 =1.198,P =0.274),lactate dehydrogenase (LDH) (≥500 U/L,x2 =0.317,P =0.573),genetic abnormality (x2 =0.377,P =0.539),immunophenotype (B-ALL/T-ALL,x2 =0.397,P =0.529),and risk stratification (low-risk group,middle-risk group and high-risk group,x2 =0.260,P =0.878).Univariate Logistic regression showed that the reaction rate of prednisone experiment (P =0.023,OR =3.422) and positive rate of MRD (P =0.001,OR =0.133) of MyAg + ALL group were obviously higher than those in MyAg-ALL group.Multivariate Logistic regression showed that positive rate of MRD in CD13 + ALL group was obviously higher than that of CD13-ALL group (P =0.034,OR =120.765).The DFS rate of CD13 + ALL group and CD13-ALL group were (50.4 ± 13.8)％ and (77.4 ±6.7)％ respectively,and there was a significant difference between the 2 groups (x2 =3.928,P =0.047).Conclusions There is no significant correlation between myeloid antigen expression and clinical characteristics of children patients with ALL.For the patients with myeloid antigens,the early reaction of induction chemotherapy is bad,and for patients with CD13,the prognosis is not good.