| Popis: |
To identify prognostic factors that can be used to further improve outcome, we studied 384 patients with this genotype treated on Chinese Children’s Cancer Group acute lymphoblastic leukemia (ALL) -2015 protocol between 1 January 2015 and 31 December 2019. All patients provisionally received intensified chemotherapy in the intermediate-risk. The overall 5-year event-free survival (EFS) was 84.4% (95% confidence interval [CI], 80.6-88.3). Independent factors associated with lower 5-year EFS were male sex (80.4%, [95% CI, 74.8-86.4] vs. 88.9%, [95% CI, 84.1-93.9] in female, p = 0.033) and positive Day 46 minimal residual disease (MRD) (≥ 0.01%) (62.1%, [95% CI, 44.2-87.4] vs. 87.1%, [95% CI, 83.4-90.9] in patients with negative MRD, p < 0.001). The presence of testicular leukemia at diagnosis (n=10) was associated with particularly poorer 5-year EFS (33.3% [95% CI, 11.6-96.1] vs. 83.0% [95% CI, 77.5-88.9] in the other 192 male patients, P < 0.001) and was an independent risk factor (HR, 5.7, [95% CI, 2.2-14.5], p < 0.001). These data suggest that the presence of positive MRD after intensive remission induction and testicular leukemia at diagnosis are indications for new molecular therapeutics or immunotherapy in patients with TCF3-PBX1 ALL. |
