Correlation analysis of baseline data, early treatment response and prognosis in children with acute lymphoblastic leukemia

doi:10.11958/20231981

Abstract

Abstract:

Objective To investigate the correlation between baseline data, early treatment response and prognosis in children with acute lymphoblastic leukemia (ALL). Methods Ninety-two children with ALL were divided into the endpoint event group (19 cases) and the event-free survival group (73 cases) according to whether there was an endpoint event (recurrence or death). The age and gender at initial diagnosis were recorded. Initial white blood cell count (WBC), platelet count (PLT), immunophenotype, chromosome karyotype, fusion gene, prednisone test, bone marrow remission status on the 15^th day of induction chemotherapy and minimal residual disease (MRD) on the 15^th, 33^rd and 55^th day of induction chemotherapy were detected. The correlation between the above baseline data and early treatment response and the occurrence of endpoint event in children with ALL was analyzed. Logistic regression was used to analyze influencing factors of endpoint events in children with ALL. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of baseline data and early treatment response to endpoint events in children with ALL. Results The proportion of WBC ≥100×10⁹/L at first diagnosis, prednisone poor reaction and positive MRD on the 33^rdday of induction chemotherapy were higher in the endpoint event group than those in the event-free survival group (P < 0.05), and there were no significance differences in remaining indicators (P > 0.05). Logistic regression analysis showed that prednisone poor reaction and positive MRD on the 33^rdday of induction chemotherapy were risk factors for endpoint event in children with ALL (P < 0.05), and the combined value of the two indicators was better than that of a single indicator in predicting endpoint events in children with ALL. Conclusion Prednisone poor reaction and positive MRD on the 33^rdday of induction chemotherapy are associated with recurrence and death in children with ALL.

Key words: precursor cell lymphoblastic leukemia-lymphoma, neoplasm, residual, prognosis, child, early treatment response

CLC Number:

R725.5

Figures/Tables 5

References 35

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组别	n	性别（男/女）	年龄（<10 岁/≥10岁）	免疫分型（B/T）	染色体核型（正常/亚二倍体/假二倍体/超二倍体）	融合基因（阴性/良性风险/不良风险）	初诊WBC（<100× 10⁹/L/≥100×10⁹/L）	初诊PLT（<20× 10⁹/L/≥20×10⁹/L）
无事件生存组	73	38/35	57/16	63/10	43/1/11/15	41/8/24	68/5	12/61
终点事件组	19	8/11	14/5	18/1	9/0/5/5	13/0/6	14/5	5/14
χ²		0.597	0.166	1.019	2.243	2.476	5.897^＊	0.976

组别	n	性别（男/女）	年龄（<10 岁/≥10岁）	免疫分型（B/T）	染色体核型（正常/亚二倍体/假二倍体/超二倍体）	融合基因（阴性/良性风险/不良风险）	初诊WBC（<100× 10⁹/L/≥100×10⁹/L）	初诊PLT（<20× 10⁹/L/≥20×10⁹/L）
无事件生存组	73	38/35	57/16	63/10	43/1/11/15	41/8/24	68/5	12/61
终点事件组	19	8/11	14/5	18/1	9/0/5/5	13/0/6	14/5	5/14
χ²		0.597	0.166	1.019	2.243	2.476	5.897^＊	0.976

组别	n	泼尼松试验（良好/不良）	骨髓形态（M1/M2/M3）	诱导化疗MRD（阴性/阳性）
组别	n	泼尼松试验（良好/不良）	骨髓形态（M1/M2/M3）	第15天	第33天	第55天
无事件生存组	73	65/8	64/3/6	50/23	57/16	58/15
终点事件组	19	11/8	14/2/1	11/6	5/9	8/6
χ²		10.180^＊	1.800	0.091	10.297^＊	3.193

组别	n	泼尼松试验（良好/不良）	骨髓形态（M1/M2/M3）	诱导化疗MRD（阴性/阳性）
组别	n	泼尼松试验（良好/不良）	骨髓形态（M1/M2/M3）	第15天	第33天	第55天
无事件生存组	73	65/8	64/3/6	50/23	57/16	58/15
终点事件组	19	11/8	14/2/1	11/6	5/9	8/6
χ²		10.180^＊	1.800	0.091	10.297^＊	3.193

变量	β	SE	Wald χ²	P	OR（95%CI）
初诊WBC	1.573	1.122	1.967	0.161	4.823（0.535~43.474）
泼尼松试验	1.624	0.826	3.861	0.049	5.072（1.004~25.618）
诱导化疗第 33天MRD	1.833	0.780	5.521	0.019	6.256（1.355~28.871）
常数项	-2.944	0.576	26.167	<0.001	0.053