Newly proposed threshold and validation of white blood cell count at diagnosis for Philadelphia chromosome-positive acute lymphoblastic leukemia: risk assessment ... View Full Text


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Article Info

DATE

2021-07-30

AUTHORS

Yu Akahoshi, Yasuyuki Arai, Satoshi Nishiwaki, Takayoshi Tachibana, Akihito Shinohara, Noriko Doki, Naoyuki Uchida, Masatsugu Tanaka, Yoshinobu Kanda, Souichi Shiratori, Yukiyasu Ozawa, Katsuhiro Shono, Yuta Katayama, Junji Tanaka, Takahiro Fukuda, Yoshiko Atsuta, Shinichi Kako

ABSTRACT

White blood cell count (WBC) at diagnosis is the conventional prognostic factor in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Nevertheless, little is known about the impact of WBC at diagnosis considering the minimal residual disease (MRD) status at allogeneic hematopoietic cell transplantation (HCT). We evaluated adult patients with Ph+ ALL who achieved negative-MRD and received HCT in first complete remission between 2006 and 2018. The entire cohort was temporally divided into derivation (n = 258) and validation cohorts (n = 366). Using a threshold of 15,000/μL, which was determined by a receiver operating characteristic curve analysis in the derivation cohort, high WBC was associated with an increased risk of hematological relapse in both the derivation cohort (25.3% vs. 11.6% at 7 years, P = 0.004) and the validation cohort (16.2% vs. 8.5% at 3 years, P = 0.025). In multivariate analyses, high WBC was a strong predictor of hematological relapse in the derivation cohort (HR, 2.52, 95%CI 1.32–4.80, P = 0.005) and in the validation cohort (HR, 2.32, 95%CI, 1.18–4.55; P = 0.015). In conclusion, WBC at diagnosis with a new threshold of 15,000/μL should contribute to better risk stratification in patients with negative-MRD at HCT. More... »

PAGES

2842-2848

References to SciGraph publications

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  • Journal

    TITLE

    Bone Marrow Transplantation

    ISSUE

    11

    VOLUME

    56

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-021-01422-7

    DOI

    http://dx.doi.org/10.1038/s41409-021-01422-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1140043948

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34331021


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