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Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group

OBJECTIVES: The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children’s Leuke...

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Autores principales: Xu, Lu-Hong, Geng, Xu, Liao, Ning, Yang, Li-Hua, Mai, Hui-Rong, Wan, Wu-Qing, Huang, Li-Bin, Zheng, Min-Cui, Tian, Chuan, Chen, Hui-Qin, Chen, Qi-Wen, Long, Xing-Jiang, Zhen, Zi-Jun, Liu, Ri-Yang, Li, Qiao-Ru, Wu, Bei-Yan, Wang, Li-Na, Kong, Xian-Ling, Chen, Guo-Hua, Fang, Jian-Pei, Li, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399517/
https://www.ncbi.nlm.nih.gov/pubmed/36033509
http://dx.doi.org/10.3389/fonc.2022.943761
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author Xu, Lu-Hong
Geng, Xu
Liao, Ning
Yang, Li-Hua
Mai, Hui-Rong
Wan, Wu-Qing
Huang, Li-Bin
Zheng, Min-Cui
Tian, Chuan
Chen, Hui-Qin
Chen, Qi-Wen
Long, Xing-Jiang
Zhen, Zi-Jun
Liu, Ri-Yang
Li, Qiao-Ru
Wu, Bei-Yan
Wang, Li-Na
Kong, Xian-Ling
Chen, Guo-Hua
Fang, Jian-Pei
Li, Yang
author_facet Xu, Lu-Hong
Geng, Xu
Liao, Ning
Yang, Li-Hua
Mai, Hui-Rong
Wan, Wu-Qing
Huang, Li-Bin
Zheng, Min-Cui
Tian, Chuan
Chen, Hui-Qin
Chen, Qi-Wen
Long, Xing-Jiang
Zhen, Zi-Jun
Liu, Ri-Yang
Li, Qiao-Ru
Wu, Bei-Yan
Wang, Li-Na
Kong, Xian-Ling
Chen, Guo-Hua
Fang, Jian-Pei
Li, Yang
author_sort Xu, Lu-Hong
collection PubMed
description OBJECTIVES: The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children’s Leukemia Group (SCCLG). METHODS: A total of 1,872 childhood patients were recruited for the study between October 2016 and July 2021. The diagnosis of CNSL depends on primary cytological examination of cerebrospinal fluid, clinical manifestations, and imaging manifestations. Patients with CNSL at diagnosis received two additional courses of intrathecal triple injections during induction. RESULTS: The frequency of CNLS at the diagnosis of B-cell ALL was 3.6%. Patients with CNSL at diagnosis had a significantly higher mean presenting leukocyte count (P = 0.002) and poorer treatment response (P <0.05) compared with non-CNSL patients. Moreover, CNSL status was associated with worse 3-year event-free survival (P = 0.030) and a higher risk of 3-year cumulative incidence of relapse (P = 0.008), while no impact was observed on 3-year overall survival (P = 0.837). Multivariate analysis revealed that CNSL status at diagnosis was an independent predictor with a higher cumulative incidence of relapse (hazard ratio = 2.809, P = 0.016). CONCLUSION: CNSL status remains an adverse prognostic factor in childhood B-cell ALL, indicating that additional augmentation of CNS-directed therapy is warranted for patients with CNSL at diagnosis.
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spelling pubmed-93995172022-08-25 Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group Xu, Lu-Hong Geng, Xu Liao, Ning Yang, Li-Hua Mai, Hui-Rong Wan, Wu-Qing Huang, Li-Bin Zheng, Min-Cui Tian, Chuan Chen, Hui-Qin Chen, Qi-Wen Long, Xing-Jiang Zhen, Zi-Jun Liu, Ri-Yang Li, Qiao-Ru Wu, Bei-Yan Wang, Li-Na Kong, Xian-Ling Chen, Guo-Hua Fang, Jian-Pei Li, Yang Front Oncol Oncology OBJECTIVES: The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children’s Leukemia Group (SCCLG). METHODS: A total of 1,872 childhood patients were recruited for the study between October 2016 and July 2021. The diagnosis of CNSL depends on primary cytological examination of cerebrospinal fluid, clinical manifestations, and imaging manifestations. Patients with CNSL at diagnosis received two additional courses of intrathecal triple injections during induction. RESULTS: The frequency of CNLS at the diagnosis of B-cell ALL was 3.6%. Patients with CNSL at diagnosis had a significantly higher mean presenting leukocyte count (P = 0.002) and poorer treatment response (P <0.05) compared with non-CNSL patients. Moreover, CNSL status was associated with worse 3-year event-free survival (P = 0.030) and a higher risk of 3-year cumulative incidence of relapse (P = 0.008), while no impact was observed on 3-year overall survival (P = 0.837). Multivariate analysis revealed that CNSL status at diagnosis was an independent predictor with a higher cumulative incidence of relapse (hazard ratio = 2.809, P = 0.016). CONCLUSION: CNSL status remains an adverse prognostic factor in childhood B-cell ALL, indicating that additional augmentation of CNS-directed therapy is warranted for patients with CNSL at diagnosis. Frontiers Media S.A. 2022-08-10 /pmc/articles/PMC9399517/ /pubmed/36033509 http://dx.doi.org/10.3389/fonc.2022.943761 Text en Copyright © 2022 Xu, Geng, Liao, Yang, Mai, Wan, Huang, Zheng, Tian, Chen, Chen, Long, Zhen, Liu, Li, Wu, Wang, Kong, Chen, Fang and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Xu, Lu-Hong
Geng, Xu
Liao, Ning
Yang, Li-Hua
Mai, Hui-Rong
Wan, Wu-Qing
Huang, Li-Bin
Zheng, Min-Cui
Tian, Chuan
Chen, Hui-Qin
Chen, Qi-Wen
Long, Xing-Jiang
Zhen, Zi-Jun
Liu, Ri-Yang
Li, Qiao-Ru
Wu, Bei-Yan
Wang, Li-Na
Kong, Xian-Ling
Chen, Guo-Hua
Fang, Jian-Pei
Li, Yang
Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title_full Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title_fullStr Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title_full_unstemmed Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title_short Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children’s Leukemia Group
title_sort prognostic significance of cnsl at diagnosis of childhood b-cell acute lymphoblastic leukemia: a report from the south china children’s leukemia group
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399517/
https://www.ncbi.nlm.nih.gov/pubmed/36033509
http://dx.doi.org/10.3389/fonc.2022.943761
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