The prognostic effect on childhood acute lymphoblastic leukemia of CD34⁺CD38⁻ expressed in leukemia cells

Figures & data

Table 1. The acute lymphocyte leukocyte CCLG-ALL 2008 program.

Therapy	Low risk	Median risk	High risk
Remission induction therapy	VDLD (DNR×2)	VDLD (DNR×4)	VDLD (DNR×4)
Early intensive treatment	CAM	CAM×2	CAM×2
Consolidation therapy	HD-MTX 2 g/m^2×4	HD-MTX 5 g/m^2×4	(HR-1’,HR-2’,HR-3’) ×2
Delayed intensive treatment	VDLD + CAM	VDLD + CAM	VDLD + CAM
Intermediate maintenance treatment	–	6-MP + MTX	–
Delayed intensive treatment	–	VDLD + CAM	–
Maintenance treatment	6-MP + MTX/VD+ Intrathecal injection	6-MP + MTX/VD+ Intrathecal injection	6-MP + MTX/CA/VD+ Intrathecal injection

Note: VDLD: Vincristine-daunorubicin-L-asparaginase-dexamethasone; DNR: daunorubicin; CAM: cyclophosphamide-cytarabine-6-mercaptopurine; HD-MTX: High-dose methotrexate; HR-1’.2’,3': BMF (Berlin-Frankfurt-Münster) collaborative group high-risk module plan 1’.2’,3’; VDLD (delayed intensive treatment I): Changchunxin Alkali-doxorubicin-L-asparaginase-dexamethasone; 6-MP: 6-mercaptopurine; MTX/CA/VD: methotrexate and (or) cyclophosphamide-cytarabine and (or) Vincristine-Dexamethasone;-No plan.

Figure 1. OS and EFS curves for 171 included children.

Table 2. Clinical and biological characteristics of the CD34⁺ and CD34⁻ groups.

Characteristics	CD34 ^+group	CD34^−group	Statistical value	P value
Gender
Male	68	31	χ^2= 0.25	0.618
Female	52	20
Age (years)	5.31 ± 3.40	5.74 ± 3.92	t = −0.71	0.479
Initial WBC [×10^9/L, M (Q25, Q75)]	14.25 (4.93,42.43)	15.40 (5.70,113.57)	Z = 1.43	0.154
Hemoglobin (g/L)	75.63 ± 23.73	79.86 ± 25.00	t = −1.05	0.295
Platelet count [×10^9/L, M (Q25, Q75)]	53.50 (25.5,91.75)	50.00 (24.00,95.00)	Z = −0.28	0.778
Bone marrow immature cells (%)	80.44 ± 17.14	82.59 ± 15.20	t = −0.78	0.443
Immunophenotyping
B	112	42	χ^2= 4.82	0.028
T	8	9
Characteristics of cytogenetics and molecular genetics
Unfavorable	22	13	χ^2= 1.13	0.289
Favorable\Other	98	38
Day 33 MRD^a
≥10^−4	31	14	χ^2= 0.05	0.817
<10^−4	87	36
Week 12 MRD^a
≥10^−3	11	7	χ^2= 0.77	0.380
<10^−3	106	43

^a Treatment of patients with early death resulted in partial data loss; WBC, white blood cell; MRD, minimal residual disease.

Figure 2. OS and EFS Kaplan–Meier curves for the CD34 + and CD34− groups. OS, EFS, and Kaplan–Meier curves for the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups.

Figure 3. Recurrence curves for the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups at different stages.

Figure 4. Kaplan–Meier curve of the recurrence rates between the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups.

Figure 5. Kaplan–Meier curve of recurrence in the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups.

Table 3. Baseline comparison between the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups (before matching).

Variable	CD34 ^+CD38^+ group	CD34 ^+CD38^−group	Statistical value	P value
Age
<1 year or≥10 years	8	11	χ^2= 2.45	0.118
≥1 year and < 10years	62	39
Initial WBC
>50×10^9/L	12	11	χ^2= 0.44	0.505
≤50×10^9/L	58	39
Immunophenotyping
B	67	45	χ^2= 0.75	0.386
T	3	5
Molecular biological characteristics
Unfavorable	13	10	χ^2= 0.038	0.845
Favorable\Other	57	40
Prednisone test
Sensitive	69	48	χ^2= 0.088	0.767
Insensitive	1	2
Day 15 bone marrow
Protoblasts≥25%	2	5	χ^2= 1.57	0.211
Protoblasts < 25%	68	45
Day 33 bone marrow
CR	67	49	χ^2= 0.26	0.612
No CR	3	1
Day 33 MRD
≥10^−4	7	18	χ^2= 11.40	0.001
<10^−4	61	32
Week 12 MRD
≥10^−3	5	6	χ^2= 0.26	0.609
<10^−3	62	44

Table 4. Baseline comparison between the CD34 ⁺CD38⁺ and CD34 ⁺CD38⁻ groups (after matching).

Variable	CD34 ^+CD38^+ group	CD34 ^+CD38^−group	Statistical value	P value
Age
<1 year or≥10 years	4	4	χ^2= 0.00	1.000
≥1 year and < 10years	32	32
Initial WBC
>50×10^9/L	7	2	χ^2= 2.03	0.154
≤50×10^9/L	29	34
Immunophenotyping
B	35	34	χ^2= 0.00	1.000
T	1	2
Molecular biological characteristics
Unfavorable	6	8	χ^2= 0.36	0.551
Favorable\Other	30	28
Prednisone test
Sensitive	36	36
Insensitive	0	0
Day 15 bone marrow
Protoblasts≥25%	0	0
Protoblasts < 25%	36	36
Day 33 bone marrow
CR	36	36
No CR	0	0
Day 33 MRD
≥10^−4	8	8	χ^2= 0.00	1.000
<10^−4	28	28
Week 12 MRD
≥10^−3	2	3	χ^2= 0.00	1.000
<10^−3	34	33