Clinical Features Of CD34-positive And CD34-negative Adult Patients With Acute T-lymphoblastic Leukemia

Background and ObjectiveAcute T lymphocyte leukemia(acute T-lymphoblastic leukemia,T-ALL)is a disease with heterogeneity of biological characteristics obviously,found more in children and adolescents and also found in adults,the morbidity of that is about 25% of adult patients wih ALL.Researches show that CD34 is highly expressed in AML,except AML-M3,which is associated with the prognosis,whereas CD34 has relatively few studies in ALL.The study of the relationship between Immunophenotyping of T-ALL and the clinical characteristics and prognosis,at present,is mainly focused on T lymphatic system of common antigen,such as CD2,CD3,CD5,CD7 and so on.For the non-specific antigen CD34,domestic and foreign research is focused on the role of the antigen in hematopoietic stem cell transplantation,its relationship with the prognosis of rarely reported.T-ALL with low morbidity,prognosis is poor,and the expression of CD34 antigen in T-ALL is not high.At present,people know little about T-ALL on biology,immunology and so on,so we can't identify reliable prognostic factors to adjust the treatment plan.The purpose of this study is to analyze the clinical features and prognosis of CD34-positive and CD34-negative adult patients with T-ALL,and to explore the value of CD34 expression for prognosis of patients with T-ALL.Methods57 adult patients diagnosed with T-ALL from January 2012 to July 2015 in the department of Haematology,the First Affiliated Hospital of Zhengzhou University,were analyzedretrospectively.According to the expression of CD34,the patients were divided into CD34-positive group and CD34-negative group,and then the clinical characteristics,laboratory examination,the incidence of central nervous system leukemia,complete remission within 4 weeks and prognosis of both groups were analyzed.While,whether CD34 expression can affect hematopoietic stem cell transplantation need to be analyzed.ResultsIn 57 patients,CD34-positive group have 13(22.8%)patients and CD34-negative group had 44(77.2%)patients.Between the two groups,There was no significant difference in these factors,such as sex,age,infiltration of liver,spleen and lymph nodes,thrombocytopenia,high white blood cell count,abnormal karyotype,complete remission within 4 weeks and central nervous system leukemia(CNSL).In addition,there is no correlation between CD34 expression with mediastinal mass.The proportions of patients with hemoglobin(Hb)<90g/L and expression of myeloid lineage marker were higher in the CD34-positive group than those in the CD34-negative group(?2=4.571,P=0.033;?2=6.787,P =0.009,respectively).In the process of treatment,43.2% of patients relapse,but had no correlation with CD34 expression.There were only 15 patients treated with hematopoietic stem cell transplantation(HSCT),42 patients were not.In patients without HSCT,the median survival time in the CD34-positive group and CD34 negative group was significant different(5 months vs.17 months,?2=4.220,P=0.040).Conclusions1.The expression of CD34 in adult T-ALL was not significantly correlated with age,sex,hepatosplenomegaly,lymphadenopathy,high white blood cell,thrombocytopenia,chromosomal abnormality and central nervous system leukemia.2.CD34 expression and mediastinal tumor,disease recurrence no clear correlation.3.CD34 positive group was more prone to moderate and severe anemia,and the expression of myeloid antigen was more likely to appear in that.4.The complete remission rate of CD34 positive group was lower than that of CD34 negative group,but there was no significant difference in both groups,may be related to fewer cases.5.The median survival time of CD34 positive group in patients with hematopoietic stem cell transplantation.was shorter than that in CD34 negative group,suggesting that CD34 expression may be one of the adverse prognostic factors of T-ALL.6.The survival rate of patients with hematopoietic stem cell transplantation was higher than that of T-ALL patients without hematopoietic stem cell transplantation,which indicated that hematopoietic stem cell transplantation was still an important treatment for acute leukemia patients.