Clinical relevance of CD10 expression in childhood ALL

Abstract

Background and Objective. Previous studies have considered the prognostic significance of CD10 expression in childhood acute lymphoblastic leukemia (ALL) and showed its linkage to a more favorable prognosis. The aim of this study was to assess the independent significance of CD10 expression in a large population of ALL patients. 
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\nDesign and Methods. We revised the independent clinical relevance of CD10 expression in 2038 children with acute lymphoblastic leukemia (ALL), who were consecutively entered in 4 sequential trials of the Italian Association for Pediatric Hematology and Oncology (i.e. AIEOP studies 82, 87, 88, 91); 1142 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. 
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\nResults. CD10 was detected in blast cells from 1706 of 1784 (95.6%) patients with B-lineage ALL and 46 of 254 (18.1%) with T-cell ALL. In the B-lineage-subgroup CD10 expression was associated with presenting features such as age < 9 yrs and inclusion in the standard risk category. No significant differences were found between CD10(+) and CD10- cases in T-lineage ALL, concerning presenting features, except for FAB L2 in the former group. We compared 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 analysis of B-lineage subgroup poorer EFS was associated with male sex, higher 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 poorer EFS in tbe T-lineage subgroup. Finally, we compared EFS rates for four groups of patients categorized as having high or standard risk, and according to CD10(+) and CD10(-) expression. High-risk patients fared statistically worse than standard risk patients both in the CD10(-) and in the CD10(+) groups (42% vs. 50.7% and 63.6% vs. 66.8%, respectively). 
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\nInterpretation and Conclusions. CD10 expression does not have independent prognostic significance in either the larger subgroup of B-ALL patients or in T-cell ALL.