Absolute lymphocyte counts refine minimal residual disease-based risk stratification in childhood acute lymphoblastic leukemia

Karen R. Rabin, M. Monica Gramatges, Michael J. Borowitz, Shana L. Palla, Xiaodong Shi, Judith F. Margolin, Patrick A. Zweidler-McKay

Research output: Contribution to journalArticle

Abstract

Background: Several studies have demonstrated the prognostic utility of absolute lymphocyte count (ALC) during therapy for a range of malignancies, with low ALC associated with adverse outcome. Here we investigated whether ALC retained independent prognostic significance with respect to minimal residual disease (MRD) status in children with acute lymphoblastic leukemia (ALL). Procedure: We reviewed 171 cases of pediatric ALL treated on the Children's Oncology Group P9900 series of treatment trials. Variables analyzed included ALC at several time points during Induction, age at diagnosis, cytogenetics, initial white blood cell count, and MRD status at Day 29 of Induction (MRD-29). Results: We found high ALC at Induction Day 29 (ALC-29) to be an independent, clinically significant predictor of improved relapse-free and overall survival (OS). Patients with ALC-29 >1,500cells/μl had a superior 6-year relapse-free survival (80±4% vs. 62±8%, P=0.018) and overall survival (96±2% vs. 74±8%, P=0.001). Moreover, ALC-29 identified distinct prognostic subgroups within cases stratified by MRD-29. In subjects with >0.01% MRD, ALC-29 > or

Original languageEnglish (US)
Pages (from-to)468-474
Number of pages7
JournalPediatric Blood and Cancer
Volume59
Issue number3
DOIs
StatePublished - Sep 2012

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Residual Neoplasm
Lymphocyte Count
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survival
Recurrence
Leukocyte Count
Cytogenetics
Pediatrics
Therapeutics

Keywords

  • ALL
  • Immunology
  • Minimal residual disease

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Absolute lymphocyte counts refine minimal residual disease-based risk stratification in childhood acute lymphoblastic leukemia. / Rabin, Karen R.; Gramatges, M. Monica; Borowitz, Michael J.; Palla, Shana L.; Shi, Xiaodong; Margolin, Judith F.; Zweidler-McKay, Patrick A.

In: Pediatric Blood and Cancer, Vol. 59, No. 3, 09.2012, p. 468-474.

Research output: Contribution to journalArticle

Rabin, Karen R. ; Gramatges, M. Monica ; Borowitz, Michael J. ; Palla, Shana L. ; Shi, Xiaodong ; Margolin, Judith F. ; Zweidler-McKay, Patrick A. / Absolute lymphocyte counts refine minimal residual disease-based risk stratification in childhood acute lymphoblastic leukemia. In: Pediatric Blood and Cancer. 2012 ; Vol. 59, No. 3. pp. 468-474.
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