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Frontiers of Medicine

, Volume 6, Issue 4, pp 416–420 | Cite as

Early T-cell precursor leukemia: a subtype of high risk childhood acute lymphoblastic leukemia

  • Meilin Ma
  • Xiang Wang
  • Jingyan Tang
  • Huiliang Xue
  • Jing Chen
  • Ci Pan
  • Hua Jiang
  • Shuhong ShenEmail author
Research Article

Abstract

Acute lymphoblastic leukemia includes T-cell acute lymphoblastic leukemia (T-ALL) and B-cell acute lymphoblastic leukemia (B-ALL). In children, T-ALL usually has a worse prognosis than B-ALL, although childhood T-ALL prognoses have improved remarkably. The varying outcomes among T-ALL cases suggest that an unrecognized biological heterogeneity may contribute to chemo-resistance. Deep exploration of T-lymphocyte development in recent years has found a subgroup of patients with a phenotype that resembles early T-cell precursor, which confers a much poorer prognosis than any other form of T-ALL. This novel subtype of T-ALL was called early T-cell precursor acute lymphoblastic leukemia (ETP-ALL). Flow cytometry data from T-ALL patients enrolled in Shanghai Children’s Medical Center between July 2002 and October 2010 were assessed according to Dr. Campana’s protocol. Among total 89 T-ALL cases, 74 cases had enough immunophenotype data available to differentiate between ETP (CD1a, CD8, CD5dim, at least one marker of stem cell or myeloid lineage) and non-ETP. From these 74 subjects, 12 ETP-ALL cases (16.2%) were identified. The event-free survival (EFS) rate at 66.8 months was 11.1% ± 10.1% for ETP-ALL and 57.6% ± 5.6% for non-ETP-ALL (P = 0.003). The overall survival rates were 13.3% ± 11.0% for ETP-ALL and 64.7% ± 6.3% for non-ETP-ALL (P = 0.002). Our findings demonstrate that early T-cell precursor leukemia is a very high-risk subtype of acute lymphoblastic leukemia with poor prognosis.

Keywords

acute lymphoblastic leukemia early T precursor prognosis 

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Copyright information

© Higher Education Press and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Meilin Ma
    • 1
  • Xiang Wang
    • 1
  • Jingyan Tang
    • 1
  • Huiliang Xue
    • 1
  • Jing Chen
    • 1
  • Ci Pan
    • 1
  • Hua Jiang
    • 1
  • Shuhong Shen
    • 1
    Email author
  1. 1.Department of Hematology/Oncology, Shanghai Children’s Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina

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