Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia

作者：Maury Sebastien^*; Huguet Francoise; Leguay Thibaut; Lacombe Francis; Maynadie Marc; Girard Sandrine; de Labarthe Adrienne; Kuhlein Emilienne; Raffoux Emmanuel; Thomas Xavier; Chevallier Patrice; Buzyn Agnes; Delannoy Andre; Chalandon Yves; Vernant Jean Paul; Rousselot Philippe; Macintyre Elizabeth; Ifrah Norbert; Dombret Herve; Bene Marie Christine

来源：Haematologica-The Hematology Journal, 2010, 95(2): 324-328.

DOI：10.3324/haematol.2009.010306

• CD20
• acute lymphoblastic leukemia
• rituximab
• prognosis

The prognostic significance of CD20 expression in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has been mostly studied in children and yielded conflicting results. In 143 adults with Philadelphia chromosome-negative BCP-ALL treated in the multicentric GRAALL 2003 trial, CD20 positivity over 20% was observed in 32% of patients. While not influencing complete remission achievement, CD20 expression was associated with a higher cumulative incidence of relapse (CIR) at 42 months (P=0.04), independently of the ALL high-risk subset (P=0.025). Notably, the negative impact of CD20 expression on CIR was only observed in patients with a white blood cell count (WBC) over 30x10(9)/L (P=0.006), while not in those with a lower WBC. In the former subgroup, this impact translated into lower event-free survival (15% vs. 59% at 42 months, P=0.003). CD20 expression thus appears to be associated with a worse outcome, which reinforces the interest of evaluating rituximab combined to chemotherapy in CD20-positive adult BCP-ALL.

• 出版日期2010-2