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Absolute lymphocyte count at the end of induction therapy is a prognostic factor in childhood acute lymphoblastic leukemia

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Abstract

Recent studies have reported that the absolute lymphocyte count (ALC) during induction therapy is predictive of treatment outcome in de novo acute lymphoblastic leukemia (ALL); however, the significance of ALC on outcomes remains controversial. In the present study, we assessed the significance of ALC at day 29 (ALC-29), the end of induction therapy, on outcomes in our Japanese cohort. The outcomes of 141 patients aged ≤18 years with newly diagnosed ALL who were enrolled on the JACLS ALL-02 at our hospitals were analyzed in terms of ALC-29. Patients with ALC-29 ≥750/μL (n = 81) had a superior 5-year EFS (95.2 ± 2.7 vs 84.3 ± 4.8 %, P = 0.016) and OS (100 vs 87.0 ± 4.7 %, P = 0.0062). A multivariate analysis identified ALC-29 ≥750/μL as a significant predictor of improved EFS and OS after controlling for confounding factors. A multiple linear regression model revealed a significant inverse relationship between the percentage of blasts in bone marrow on day 15 and ALC-29 (P = 0.005). These results indicate that ALC is a simple prognostic factor in childhood ALL, and, thus, has the potential to refine current risk algorithms.

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Acknowledgments

The authors thank Mrs. Hiroko Wada for her special assistance in this study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Satoshi Hirase, Nobuyuki Yamamoto, Ikuko Kubokawa, Takeshi Mori, Akira Hayakawa, Noriyuki Nishimura & Kazumoto Iijima

  2. Department of Hematology and Oncology, Kobe Children’s Hospital, 1-1-1, Takakuradai, Suma, Kobe, 654-0081, Japan

    Daiichiro Hasegawa, Atsuro Saito, Aiko Kozaki, Toshiaki Ishida, Tomoko Yanai, Keiichiro Kawasaki & Yoshiyuki Kosaka

  3. Department of Pediatrics, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji Hyōgo, 670-8540, Japan

    Hironobu Takahashi

  4. Department of Medical Statistics, Kobe Pharmaceutical University, 4-19-1 Motoyamakitamachi Higashinada, Kobe, 658-8558, Japan

    Kensuke Moriwaki

  5. Department of Epidemiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Noriyuki Nishimura & Hisahide Nishio

Authors
  1. Satoshi Hirase
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  2. Daiichiro Hasegawa
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  3. Hironobu Takahashi
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  4. Kensuke Moriwaki
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  5. Atsuro Saito
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  6. Aiko Kozaki
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  7. Toshiaki Ishida
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  8. Tomoko Yanai
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  9. Keiichiro Kawasaki
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  10. Nobuyuki Yamamoto
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  11. Ikuko Kubokawa
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  12. Takeshi Mori
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  13. Akira Hayakawa
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  14. Noriyuki Nishimura
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  15. Hisahide Nishio
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  16. Kazumoto Iijima
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  17. Yoshiyuki Kosaka
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Corresponding author

Correspondence to Daiichiro Hasegawa.

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The authors declare no conflict of interest.

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Hirase, S., Hasegawa, D., Takahashi, H. et al. Absolute lymphocyte count at the end of induction therapy is a prognostic factor in childhood acute lymphoblastic leukemia. Int J Hematol 102, 594–601 (2015). https://doi.org/10.1007/s12185-015-1875-0

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  • DOI: https://doi.org/10.1007/s12185-015-1875-0

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