Long-term Follow-up And Prognostic Factor Analysis Of Acute Lymphoblastic Leukemia In Young Children

ObejectiveTo evaluate the prognostic factors of acute lymphoblastic leukemia(ALL)in young children,who were enrolled in Shanghai Children’s Medical Center-Acute Lymphoblastic Leukemia-2005(SCMC-ALL-2005)study based on collaboration.MethodsBetween May 2005 and December 2014,303 newly diagnosed ALL patients were enrolled and treated in 5 hospitals of SCMC-ALL-2005 multicenter study group,using risk-stratified SCMC-ALL-2005 protocol.Risk group classification and treatment intensity were based on clinical features,genetic abnormalities,early response to treatment and levels of minimal residual disease(MRD).Kaplan-Meier method was used to generate overall survival(OS)and event-free survival(EFS)and cumulative incidence of relapse(CIR)curves.Cox proportional hazards models were used for multivariate analyses.Resultsthe median follow-up time was 72 months.The 5-year and 10-year EFS rates were(71.0±2.7)%and(68.4±2.9)%.The 5-year and 10-year OS rates were(75.9±2.5%)and(73.3±2.9)%.The 10-year EFS rates for low risk(LR),intermediate risk(IR)and high risk(HR)were(79.9±4.5)%and(66.4±3.7)and(23.5±0.3)%.62 patients relapsed(20.3%),including49 bone marrow,3 central nerve system(CNS),7 testis,1 both in bone marrow and CNS,1both in bone marrow and testis,1 both in CNS and testis.The long term prognosis is poor for WBC count at diagnosed was equal or more than 50×10~9/l,patients with ALL under 1 year of age,prednisolone poor responder or positive MRD results on day 55.ConclusionIn this large sample research,the overall outcome of young children ALL for multi-center SCMC-ALL-2005 study was favorable.This helps to promote the standardized treatment of young children ALL to the whole country.MRD results on day 55 of induction therapy,WBC count at diagnosed,prednisolone good or poor responder,diagnosed age have important prognostic and therapeutic implications.