Vol. 13 No. 1 (2021): Archives of Public Health (OnlineFirst)
Review

Prognostic factors of childhood acute lymphoblastic leukemia –review of literature

Kata Martinova
University Clinic for chidren's diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia

Published 2021-03-15

Keywords

  • acute lymphoblastic leukemia,
  • children,
  • prognostic factors,
  • minimal residual disease,
  • survival

How to Cite

1.
Јовановска А, Мартинова К. Prognostic factors of childhood acute lymphoblastic leukemia –review of literature. Arch Pub Health [Internet]. 2021 Mar. 15 [cited 2021 Apr. 16];13(1):1-16. Available from: https://id-press.eu/aph/article/view/5732

Abstract

The treatment outcome of acute lymphoblastic leukemia (ALL)has remarkably improved over the recent decades, leading to a 5-year overall survival rate up to 90%. This impressive achievement is mainly due to the use of effective multi-agent chemotherapy regimens and the precise stratification of patients into risk groups based on well defined prognostic factors including the clinical features that are present at diagnosis, biologic and genetic features of leukemia cells, and early response to treatment. Patients classified as low risk are treated with less intensive therapy, whereas more aggressive regimens are reserved for those with high-risk features. Currently, minimal residual disease (MRD) is the most important and independent predictor of treatment outcome. This review will describe the clinical, biological, and response-based features and current evidence supporting their clinical application in childhood ALL.

 

Downloads

Download data is not yet available.

References

  1. Moricke A, Zimmermann M, Valsecchi MG, et al. Dexamethasone vs prednisone in induction treatment of pediatric ALL: results of the randomized trial AIEOP-BFM ALL 2000. Blood 2016; 127(17): 2101–12.
  2. Vora A, Goulden N, Mitchell C, et al. Augmented post-remission therapy for a minimal residual disease-defined high-risk subgroup of children and young people with clinical standard-risk and intermediate-risk acute lymphoblastic leukaemia (UKALL 2003): a randomised controlled trial. Lancet Oncol 2014; 15(8): 809–18.
  3. Pieters R, de Groot-Kruseman H, Van der Velden V, et al. Successful therapy reduction and intensification for childhood acute lymphoblastic leukemia based on minimal residual disease monitoring: Study ALL10 from the Dutch Childhood Oncology Group. Journal of Clinical Oncology 2016; 34(22): 2591–601.
  4. Domenech C, Suciu S, De Moerloose B, et al. Dexamethasone (6 mg/m2/day) and prednisolone (60 mg/m2/day) were equally effective as induction therapy for childhood acute lymphoblastic leukemia in the EORTC CLG 58951 randomized trial. Haematologica 2014;99(7):1220-7
  5. Hunger SP, Lu X, Devidas M, et al. Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990 and 2005: a report from the Children's Oncology Group. J Clin Oncol 2012;30, 1663–1669.
  6. Pui CH, Pei D, Coustan-Smith E, et al. Clinicalutility of sequential minimal residual disease measurements in the context of risk-based therapy in childhood acute lymphoblastic leukaemia: a prospective study. Lancet Oncol 2015;16(4):465-74.
  7. Place AE, Stevenson KE, Vrooman LM, et al. Intravenous pegylated asparaginase versus intramuscular native Escherichia coli L-asparaginase in newly diagnosed childhood acute lymphoblastic leukaemia (DFCI 05–001): a randomised, open-label phase 3 trial. Lancet Oncol 2015; 16(16): 1677–90.
  8. Oskarsson T, Söderhäll S, J, et al. Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome. Haematologica 2016; 101(1): 68–76.
  9. Pieters R, Schrappe M, De Lorenzo P, et al. A treatment protocol for infants younger than 1 year with acute lymphoblastic leukaemia (Interfant-99): An observational study and a multicentre randomised trial. Lancet 2007;370(9583):240-250.
  10. Mullighan CG, Su X, Zhang J, et al. Deletion of IKZF1 and prognosis in acute lymphoblastic leukemia. N Engl J Med 2009; 360(5):470-80.
  11. Den Boer ML, van Slegtenhorst M, De Menezes RX, et al. A subtype of childhood acute lymphoblastic leukaemia with poor treatment outcome: a genome-wide classification study. Lancet Oncol 2009; 10(2):125-34.
  12. van der Veer A, Waanders E, Pieters R, et al. Independent prognostic value of BCR-ABL1-like signature and IKZF1 deletion, but not high CRLF2 expression in children with B-cell precursor ALL. Blood 2013;122(15):2622-9.
  13. Smith M, Arthur D, Camitta B,et al. Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic leukemia. J Clin Oncol 1996;14(1):18-24.
  14. Moricke A, Zimmermann M, Reiter A, et al. Prognostic impact of age in children and adolescents with acute lymphoblastic leukemia: data from the trials ALL-BFM 86, 90, and 95. Klin Padiatr 2005;217(6):310-20.
  15. Forestier E, Schmiegelow K. The incidence peaks of the childhood acute leukemias reflect specific cytogenetic aberrations. J Pediatr Hematol Oncol 2006;28(8):486-95.
  16. ConterV, Bartram CR, ValsecchiMG,et al. Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study. Blood 2010;115(16):3206-14.
  17. Borowitz MJ, Wood BL,Devidas M, et al. Prognostic significance of minimal residual disease in high risk B-ALL: a report from Children's Oncology Group study AALL0232. Blood 2015;126(8):964-71.
  18. Maloney KW, Shuster JJ, Murphy S, et al. Long-term results of treatment studies for childhood acute lymphoblastic leukemia: Pediatric Oncology Group studies from 1986-1994. Leukemia 2000; 14:2276.
  19. Pullen J,Shuster JJ, Link M, et al. Significance of commonly used prognostic factors differs for children with T cell acute lymphocytic leukemia (ALL), as compared to those with B-precursor ALL. A Pediatric Oncology Group (POG) study. Leukemia 1999;13(11):1696-707.
  20. PuiCH, Howard SC. Current management and challenges of malignant disease in the CNS in paediatric leukaemia Lancet Oncol 2008;9(3):257-68.
  21. Pui CH, Campana D, Pei D, et al. Treating childhood acute lymphoblastic leukemia without cranial irradiation. N Engl J Med 2009;360(26):2730-41.
  22. Veerman AJ, Kamps WA, van den Berg H, et al. Dexamethasone-based therapy for childhood acute lymphoblastic leukaemia: results of the prospective Dutch Childhood Oncology Group (DCOG) protocol ALL-9 (1997-2004). Lancet Oncol 2009;10:957-966.
  23. Wood BL, Winter SS, Dunsmore KP, et al. T-Lymphoblastic Leukemia (T-ALL) shows excellent outcome, lack of significance of the early thymic precursor (ETP) immunophenotype, and validation of the prognostic value of end-induction minimal residual disease (MRD) in Children’s Oncology Group (COG) Study AALL0434. Blood 2014;124(21):1.
  24. Coustan-Smith E, Mullighan CG, Onciu M, et al. Early T-cell precursor leukaemia: a subtype of very high-risk acute lymphoblastic leukaemia. Lancet Oncol 2009; 10:147.
  25. Conter V, Valsecchi MG, Buldini B, et al. Early T-cell precursor acute lymphoblastic leukaemia in children treated in AIEOP centres with AIEOP-BFM protocols: a retrospective analysis.Lancet Haematol 2016;3(2):e80-6.
  26. Moorman AV, Ensor HM, Richards SM, et al. Prognostic effect of chromosomal abnormalities in childhood B-cell precursor acute lymphoblastic leukaemia: results from the UK Medical Research Council ALL97/99 randomised trial. Lancet Oncol 2010;11:429–438.
  27. Moorman AV. New and emerging prognostic and predictive genetic biomarkers in B-cell precursor acute lymphoblastic leukemia.Haematologica 2016; 101(4):407-16.
  28. Mann G, Attarbaschi A, Schrappe M, et al. Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineage-leukemia (MLL)-rearranged acute lymphoblastic leukemia: results from the Interfant-99 Study. Blood 2010; 116(15): 2644–50.
  29. Brown P, Kairalla J, Wang C, et al. Addition of FLT3 inhibitor Lestaurtinib to post-induction chemotherapy does not improve outcomes in MLL-rearranged infant acute lymphoblastic leukemia (All): AALL0631, A Children’s Oncology Group Study. Pediatric blood & cancer (SIOP 2016 Scientific Programme+Index) 2016; 63(Suppl S3, S5) abstract O-001.
  30. Schultz KR, Carroll A, Heerema NA, et al. Long-term follow-up of imatinib in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia: Children's Oncology Group study AALL0031.Leukemia 2014; 28(7):1467-71.
  31. Cazzaniga G, De Lorenzo P, Alten J, et al. Predictive value of MRD in Ph+ ALL treated with imatinib in the EsPhALL study, based on IG/TR and BCR/ABL1 methodologies. Haematologica 2017; 103(1).
  32. Holmfeldt L, Wei L, Diaz-Flores E, et al. The genomic landscape of hypodiploid acute lymphoblastic leukemia. Nat Genet 2013;45:242–252.
  33. Mullighan CG, Jeha S, Pei D, et al. Outcome of children with hypodiploid ALL treated with risk-directed therapy based on MRD levels. Blood 2015; 126(26): 2896–9.
  34. Jeha S, Pei D, Raimondi SC, et al. Increased risk for CNS relapse in pre-B cell leukemia with the t(1;19)/TCF3-PBX1. Leukemia 2009; 23(8):1406-9.
  35. Tasian SK, Hunger SP. Genomic characterization of paediatric acute lymphoblastic leukaemia: an opportunity for precision medicine therapeutics. Br J Haematol 2017; 176: 867–82.
  36. Moorman AV, Robinson H, Schwab C, et al. Risk-directed treatment intensification significantly reduces the risk of relapse among children and adolescents with acute lymphoblastic leukemia and intrachromosomal amplification of chromosome 21: a comparison of the MRC ALL97/99 and UKALL2003 trials. J Clin Oncol 2013; 31(27):3389-96.
  37. Harrison CJ, Moorman AV, Schwab C, et al. An international study of intrachromosomal amplification of chromosome 21 (iAMP21): cytogenetic characterization and outcome. Leukemia 2014; 28(5):1015-21.
  38. Roberts KG, Pei D, Campana D, et al. Outcomes of children with BCR-ABL1–like acute lymphoblastic leukemia treated with risk-directed therapy based on the levels of minimal residual disease. J Clin Oncol 2014;32:3012–3020.
  39. Roberts KG, Li Y, Payne-Turner D, et al. Targetable kinase-activating lesions in Ph-like acute lymphoblastic leukemia. N Engl J Med 2014; 371(11): 1005–15.
  40. Harvey RC, Mullighan CG, Chen IM, et al. Rearrangement of CRLF2 is associated with mutation of JAK kinases, alteration of IKZF1, Hispanic/Latino ethnicity, and a poor outcome in pediatric B-progenitor acute lymphoblastic leukemia. Blood. 2010;115:5312–5321.
  41. Cario G, Zimmermann M, Romey R, et al. Presence of the P2RY8-CRLF2 rearrangement is associated with a poor prognosis in non-high-risk precursor B-cell acute lymphoblastic leukemia in children treated according to the ALL-BFM 2000 protocol. Blood 2010;115:5393–5397.
  42. Riehm H, Reiter A, Schrappe M, et al. Corticosteroid-dependent reduction of leukocyte count in blood as a prognostic factor in acute lymphoblastic leukemia in childhood (therapy study ALL-BFM 83)] Klin Padiatr 1987;199(3):151–60.
  43. Steinherz PG, Gaynon PS, Breneman JC, et al. Cytoreduction and prognosis in acute lymphoblastic leukemia - the importance of early marrow response: report from the Childrens Cancer Group. J Clin Oncol 1996;14(2):389–98.
  44. Schrappe M, Reiter A, Zimmermann M, et al. Long-term results offour consecutive trialsin childhood ALL performedby the ALL-BFM study group from1981 to 1995. Berlin-Frankfurt-Münster. Leukemia 2000;14(12):2205-22.
  45. Lauten M, Möricke A, Beier R, Zimmermann M, Stanulla M, Meissner B, et al. Prediction of outcome by early bone marrow response in childhood acute lymphoblastic leukemia treated in the ALL-BFM 95 trial: differential effects in precursor B-cell and T-cellleukemia. Haematologica 2012;97(7):1048–1056.
  46. StaryJ, Zimmermann M, Campbell M, et al. Intensive Chemotherapy for Childhood Acute Lymphoblastic Leukemia: Results of the Randomized Intercontinental Trial ALL IC-BFM 2002. J Clin Oncol 2014; 32(3):174–184.
  47. Schrappe M, Hunger SP, Pui CH, et al. Outcomes after induction failure in childhood acute lymphoblastic leukemia. N Engl J Med 2012;366(15):1371-1381.
  48. Oudot C, Auclerc MF, Vincent Levy V, еt al. Prognostic factors for leukemic induction failure in children with acute lymphoblastic leukemia and outcome after salvage therapy: the FRALLE 93 study. J Clin Oncol 2008;26(9):1496-503.
  49. Möricke A, Reiter A, Zimmermann M, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95. Blood 2008; 111: 4477–4489.
  50. Coustan-Smith Е, Behm FG, Sanchez J, et al. Immunological detection of minimal residual disease in children with acute lymphoblastic leukaemia. Lancet 1998;351(9102):550-4.
  51. Coustan-Smith E, Sancho J, Behm FG, et al. Prognostic importance of measuring early clearance of leukemic cells by flow cytometry in childhood acute lymphoblastic leukemia. Blood 2002;100(1):52-58.
  52. Dworzak MN, Fröschl G, Printz D, et al. Prognostic significance and modalities of flow cytometric minimal residual disease detection in childhood acute lymphoblastic leukemia. Blood 2002;99(6):1952-1958.
  53. Borowitz MJ, Devidas M, Hunger SP, et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study. Blood 2008;111(12):5477-5485.
  54. Yeoh AE, Ariffin H, Chai EL, et al. Minimal residual disease-guided treatment deintensification for children with acute lymphoblastic leukemia: results from the Malaysia-Singapore acute lymphoblastic leukemia 2003 study. J Clin Oncol 2012;30(19):2384-92.
  55. Schrappe M, Valsecchi MG, Bartram CR, et al. Late MRD response determines relapse risk overall and in subsets of childhood T-cell ALL: results of the AIEOP-BFM-ALL 2000 study. Blood 2011;118(8):2077-84.
  56. Vora A, Goulden N, Wade R, et al. Treatment reduction for children and young adults with low-risk acute lymphoblastic leukaemia defined by minimal residual disease (UKALL 2003): a randomised controlled trial. Lancet Oncol 2013;14(3):199–209.
  57. Bader P, Kreyenberg H, Henze GHR, et al. Prognostic value of minimal residual disease quantification before allogeneic stem-cell transplantation in relapsed childhood acute lymphoblastic leukemia: the ALL-REZ BFM study group. J Clin Oncol 2009;27:377–84.
  58. Brüggemann М, Gökbuget N and Kneba M. Acute lymphoblastic leukemia: monitoring minimal residual disease as a therapeutic principle. Semin Oncol 2012;39(1):47-57.
  59. Basso G, Veltroni M, Valsecchi MG, et al. Risk of relapse of childhood acute lymphoblastic leukemia is predicted by flow cytometric measurement of residual disease on day 15 bone marrow.J Clin Oncol 2009; 27(31):5168-74.
  60. Sutton R, Venn NC, Tolisano J, et al. Australian and New Zealand Children’s Oncology Group. Clinical significance of minimal residual disease at day 15 and at the end of therapy in childhood acute lymphoblastic leukaemia. Br J Haematol 2009;146:292–299.