Clinical relevance of CD10 expression in childhood ALL

Background and Objective. Previous studies have considered the prognostic s ignificance of CD10 expression in childhood acute lymphoblastic leukemia (A LL) and showed its linkage to a more favorable prognosis. The aim of this s tudy was to assess the independent significance of CD10 expression in a lar ge population of ALL patients. Design and Methods. We revised the independent clinical relevance of CD10 e xpression in 2038 children with acute lymphoblastic leukemia (ALL), who wer e consecutively entered in 4 sequential trials of the Italian Association f or Pediatric Hematology and Oncology (i.e. AIEOP studies 82, 87, 88, 91); 1 142 were males and 896 females, age ranged between 1 and 14 years (yrs) at diagnosis. Of the whale group, 1471 children (72.2%) were defined as having standard risk, 567 (27.8%) as having a high risk. Results. CD10 was detected in blast cells from 1706 of 1784 (95.6%) patient s with B-lineage ALL and 46 of 254 (18.1%) with T-cell ALL. In the B-lineag e-subgroup CD10 expression was associated with presenting features such as age < 9 yrs and inclusion in the standard risk category. No significant dif ferences were found between CD10(+) and CD10- cases in T-lineage ALL, conce rning presenting features, except for FAB L2 in the former group. We compar ed the event-free survival (EFS) rates for patients with T-ALL or B-lineage ALL, regarding CD10 positivity, overall and by individual study. Patients with T-ALL fared worse than those with B-lineage ALL (5 and 10 yrs EFS: 46. 8% vs. 68.5% and 44.5% vs. 63.7% respectively, p=0.0001). In multivariate a nalysis of B-lineage subgroup poorer EFS was associated with male sex, high er WBC (greater than or equal to 20x10(9)/L), age > 9 yrs. Only WBC greater than or equal to 20x10(9)/L and age > 9 yrs were parameters linked to poor er EFS in tbe T-lineage subgroup. Finally, we compared EFS rates for four g roups of patients categorized as having high or standard risk, and accordin g to CD10(+) and CD10(-) expression. High-risk patients fared statistically worse than standard risk patients both in the CD10(-) and in the CD10(+) g roups (42% vs. 50.7% and 63.6% vs. 66.8%, respectively). Interpretation and Conclusions. CD10 expression does not have independent p rognostic significance in either the larger subgroup of B-ALL patients or i n T-cell ALL. (C)1998, Ferrata Storti Foundation.