| ObjectiveTo explore the relationship between the expression of different Immunophenotype and the clinical characteristics of children with Acute Lymphoblastic Leukemia(ALL),and to analyze the effect of antigen expression on chemotherapy effect.MethodsWe retrospectively analyzed the clinical information of 271 patients treated with CCCG-ALL-2015 Protocol between January 2015 and December 2019 in our hospital.We analysed clinical information,and the antigen expression rate,.We compared different immune differentiation antigen expression and clinical characteristics,the fusion gene expression,MRD,prognosis.ResultA total of 271 patients were included in this study,including 249 cases of B-ALL(91.9%)and 22 cases of T-ALL(8.1%).The major B-ALL antigens included CD 19(100%),HLA-DR(99.6%),and CD 10(93.6%),while the major T-ALL expressed cCD3(100%),CD7(90.9%),CD38(68.2%),CD34(63.6%),and TDT(63.6%).The proportion of children over 10 years in T-ALL group was higher than that in B-ALL group,and the difference between the two groups was statistically significant(P<0.05).The WBC count in T-ALL group was higher than that in B-ALL group(P<0.05).The expression rate of TEL/AML1 in B-ALL group was higher than that in T-ALL group(P<0.05).The rate of E2A/PBX1 in CD34-B-ALL was higher than that in CD34+B-ALL(P<0.05).CD10-B-ALL had higher WBC count the number than CD10-B-ALL(P<0.05).There was no statistically significant difference between positive and negative CD20 in clinical characteristics(P<0.05).All the fusion gene positive groups expressed CD19,but did not express CD3,CD4,CD5,CD8.The proportion of D19 MRD≥1%in T-ALL group was higher than that in B-ALL group,and the difference was statistically significant(P<0.05).The proportion of D19 MRD≥1%in the CD10+group was lower than that in the CD 10-group,and the difference was statistically significant(P<0.05).The proportion of D19 MRD≥1%in the CD22+group was lower than that in the CD 10group,and the difference was statistically significant(P<0.05).The 3-year overall survival rate(OS)of B-ALL group was better than that of T-ALL group(97.2%vs 78.6%,P<0.05),and the 3-year event-free survival rate(EFS)of B-ALL group was better than that of T-ALL group(91.6%vs 71.4%,P<0.05).The 3-years OS of CD 10 positive group was better than that of negative group(96.4%vs 87.0%,P<0.05),and the 3-year EFS of CD 10 positive group was better than that of CD 10 negative group(91.8%vs 78.3%,P<0.05).The 3-year OS of CD22 positive group was better than that of negative group(96.9%vs 87.5%,P<0.05).Multivariate analysis suggested that T cell type was an independent predictor of mortality risk in children with ALL.Conclusion1.CD 19 and HLA-DR are the most valuable antigens for the diagnosis of B-ALL.cCD3 and CD7 can be used as a marker for differentiation of T-ALL.2.The expression of some CD is correlated with the clinical characteristics of the children which is suggestive of the prognosis.3.The positive immunoantigen expression of different fusion genes has its own characteristics,and the combined detection is of great significance for the diagnosis and classification of ALL.4.CD10+may indicate a good prognosis. |
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