Early T-cell precursor acute lymphoblastic leukemia and other subtypes: a retrospective case report from a single pediatric center in China

• Published in: Journal of cancer research and clinical oncology Vol. 147; no. 9; pp. 2775 - 2788
• Main Authors: Liu, Xiaoming, Zou, Yao, Zhang, Li, Chen, Xiaojuan, Yang, Wenyu, Guo, Ye, Chen, Yumei, Zhang, Yingchi, Zhu, Xiaofan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2021; Springer Nature B.V
• Subjects: Acute lymphoblastic leukemia; Cancer Research; Case reports; Central nervous system; Children; Hematology; Internal Medicine; Leukemia; Lymphatic leukemia; Lymphocytes T; Medical prognosis; Medicine; Medicine & Public Health; Multivariate analysis; Oncology; Original Article – Clinical Oncology; Patients; Pediatrics; China; Prognosis; Immunophenotype; Early T-cell precursor; Child; T-cell acute lymphoblastic leukemia
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-021-03551-4

Purpose Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is rare in China and case reports are varied. We conducted an in-depth analysis of newly diagnosed children with T-ALL from January 1999 to April 2015 in our center, to show the biological differences between Chinese ETP-ALL children and other immune types of T-ALL. Methods The newly diagnosed children with T-ALL were divided into four groups according to their immunophenotype: ETP-ALL, early non-ETP-ALL, cortical T-ALL and medullary T-ALL. Disease-free survival (DFS), event-free survival (EFS), and overall survival (OS) rates were estimated by the Kaplan–Meier method. The Cox regression model was used for multivariate analysis. Results A total of 117 newly diagnosed children with T-ALL were enrolled in this study. The 10-year EFS and OS rates for all patients were 59.0 ± 4.7% and 61.0 ± 4.7%, respectively, with a median follow-up of 64 (5–167) months. Univariate analysis showed that ETP-ALL patients had the lowest 10-year DFS rate of 32.1 ± 11.7%, while cortical T-ALL had the highest DFS rate of 81.3 ± 8.5% compared with early non-ETP-ALL (61.6 ± 7.0%) and medullary T-ALL (59.1 ± 10.6%). Multivariate analysis demonstrated that only ETP-ALL and involvement of the central nervous system were independent prognostic factors. Conclusion Compared with other subtypes, pediatric ETP-ALL had a poor treatment response and high recurrence rate while cortical T-ALL appeared to have much better outcome. Our observations highlight the need for an individualized treatment regime for ETP-ALL.