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Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children's Leukemia Group. | LitMetric

AI Article Synopsis

  • * Out of 1,872 pediatric patients analyzed, 3.6% had CNSL at diagnosis, which was linked to higher leukocyte counts, poorer treatment responses, and a reduced event-free survival rate.
  • * The findings suggest that CNSL at diagnosis is a negative prognostic factor, indicating the need for enhanced CNS-targeted therapy for these patients.

Article Abstract

Objectives: The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children's Leukemia Group (SCCLG).

Methods: A total of 1,872 childhood patients were recruited for the study between October 2016 and July 2021. The diagnosis of CNSL depends on primary cytological examination of cerebrospinal fluid, clinical manifestations, and imaging manifestations. Patients with CNSL at diagnosis received two additional courses of intrathecal triple injections during induction.

Results: The frequency of CNLS at the diagnosis of B-cell ALL was 3.6%. Patients with CNSL at diagnosis had a significantly higher mean presenting leukocyte count ( = 0.002) and poorer treatment response (0.05) compared with non-CNSL patients. Moreover, CNSL status was associated with worse 3-year event-free survival ( = 0.030) and a higher risk of 3-year cumulative incidence of relapse( = 0.008), while no impact was observed on 3-year overall survival ( = 0.837). Multivariate analysis revealed that CNSL status at diagnosis was an independent predictor with a higher cumulative incidence of relapse (hazard ratio = 2.809, = 0.016).

Conclusion: CNSL status remains an adverse prognostic factor in childhood B-cell ALL, indicating that additional augmentation of CNS-directed therapy is warranted for patients with CNSL at diagnosis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399517PMC
http://dx.doi.org/10.3389/fonc.2022.943761DOI Listing

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