CD20 positivity and white blood cell count predict treatment outcomes in Philadelphia chromosome-negative acute lymphoblastic leukemia patients ineligible for pediatric-inspired chemotherapy
| Autor: | Ryuko Cho, Masahiro Onoda, Hiroaki Tanaka, Nobuyuki Aotsuka, Yusuke Isshiki, Emiko Sakaida, Chikako Ohwada, Takeharu Kawaguchi, Akira Yokota, Takeaki Sugawara, Motoharu Fukazawa, Satoru Hara |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Philadelphia Chromosome Negative Hematopoietic stem cell transplantation Leukocyte Count Young Adult 03 medical and health sciences 0302 clinical medicine immune system diseases hemic and lymphatic diseases Internal medicine White blood cell Acute lymphocytic leukemia medicine Humans Philadelphia Chromosome Radiology Nuclear Medicine and imaging Aged Retrospective Studies CD20 Chemotherapy biology business.industry Hematopoietic Stem Cell Transplantation General Medicine Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma Antigens CD20 medicine.disease Chemotherapy regimen Regimen Treatment Outcome surgical procedures operative medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis biology.protein Female business 030215 immunology |
| Zdroj: | Japanese Journal of Clinical Oncology. 47:1047-1054 |
| ISSN: | 1465-3621 0368-2811 |
| Popis: | Background The efficacy of conventional chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been controversial as post-remission therapies for adult Philadelphia chromosome-negative acute lymphoblastic leukemia patients. Methods We retrospectively analyzed 96 adolescent and adult cases of Philadelphia chromosome-negative acute lymphoblastic leukemia to evaluate whether allo-HSCT should be performed after first complete remission (1CR). Results In total, 34 patients received chemotherapy followed by allo-HSCT (HSCT group) and 62 received chemotherapy alone (chemotherapy group). No significant differences in the event-free survival (EFS) or overall survival were observed between the two groups. In the chemotherapy group, use of pediatric regimens was significantly associated with favorable EFS, while high white blood cell (WBC) count and CD20 positivity were associated with poor outcome. In patients who received pediatric regimens, subsequent allo-HSCT did not influence EFS. In patients who received conventional chemotherapy (adult regimen), subsequent allo-HSCT did not improve EFS. High WBC count and CD20 positivity were also significantly associated with poor EFS in patients who received adult regimens. Patients with low WBC count and absence of CD20 who received adult regimens did not benefit from allo-HSCT. Conclusions Allo-HSCT may not be required in the pediatric regimen-eligible patients; however, pediatric regimen-ineligible patients with either CD20 positivity or high WBC count should receive allo-HSCT after achieving 1CR. This study was registered at http://www.umin.ac.jp/ctr/ as #C000016287. |
| Databáze: | OpenAIRE |
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