Treatment of children with highly suspected mature B-cell lymphoblastic leukemia

Abstract

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL)and to assess the safety and efficacy of the treatment protocol. Methods From February of 2003 to December of 2012, 15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled, and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol .All of the clinical characteristics, therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0. Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months). Among them, 4 cases presented with local mass including maxillofacial tumors, neck and abdominal mass.The others had systemic manifestations such as fever and pale face. These neoplastic cells retained the expressions of surface membrane immunoglobulin M, terminal deoxynucleotidyl transferase, Cμ, CD10, CD19, cCD79a differently.Follow-up was updated to November 30, 2013.The median follow-up period was 80 months(39-128 months). Theestimated 5-year event free survival rate was (80.0±10.3)%.According to univariate analysis, increased lactate dehydrogenase level (> 4-times the normal value), increased serum ferritin level (> 2-times the normal value), no small residual disease markers were indepen-dent poor prognostic factors(χ2=5.49, 4.89, 5.49, all P<0.05). Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp, but more sample cases need to be investigated. Key words: Mature B-cell acute lymphoblastic leukemia/lymphoma; Child; Curative effect; Event-free survival