Cytogenetic Characteristics of Childhood Acute Lymphoblastic Leukemia: A Study of 1541 Chinese Patients Newly Diagnosed between 2001 and 2014

Identifying Typologies of Symptoms and Functional Impairments in Chinese Children With Leukemia and Their Population Characteristics: A Latent Profile Analysis

BACKGROUND

Symptom distress and functional impairments in children with leukemia directly affect their quality of life.

OBJECTIVES

To identify subgroups of symptom distress and functional impairments in Chinese children with leukemia and to examine the associations of the latent classes with individual characteristics.

METHODS

This multicenter cross-sectional survey study recruited children with leukemia who received chemotherapy in 4 hospitals in Shanghai, Jiangsu, Zhejiang, and Guangdong Province. The participants were surveyed via PROMIS-25 (Patient-Reported Outcomes Measurement Information System Pediatric-25 Profile). Latent profile analysis and multinomial logistic regression model were performed to identify subgroups of symptom distress and function impairments among children with leukemia.

RESULTS

Latent profile analysis results suggested the classification of 3 subgroups: profile 1: "moderate symptom distress, moderate mobility impairment with fair peer relationship function" group (69, 28.3%), profile 2: "mild symptom distress, no mobility impairment with good peer relationship function" group (97, 39.8%), and profile 3: "no symptom distress, no mobility impairment with good peer relationship function" group (78, 32.0%). Sociodemographic characteristics, including gender of the children, gender and marital status of the parents, average monthly income of the family, and reimbursement ratio of treatment expenses, had significant associations with the latent profile membership ( P < .05).

CONCLUSION

This study identified 3 distinct profiles of symptom distress and functional impairments in children with leukemia and found significant associations between these profiles and sociodemographic characteristics.

IMPLICATIONS FOR PRACTICE

The classification of the 3 latent profiles in children with leukemia helps to provide targeted supportive intervention to those children and their families.

Missing the mark? Exploratory analysis of the 10-year-old cutoff as an independent marker of high-risk disease in pediatric B-ALL

This single-center, retrospective study evaluated age as a risk factor for relapsed/refractory disease and/or death in 153 children with B-cell acute lymphoblastic leukemia. The study sample included children near the 10-year age cutoff for high-risk disease (6.0-13.9 years at diagnosis) and without other high-risk features (high white cell count, unfavorable cytogenetics). Children 10.0-13.9 years treated per high-risk protocols did not have inferior outcomes compared with children aged 6.0-9.9 years initiating treatment per standard-risk protocols. The study indicates that, in the era of cytogenetics, an age threshold of 10 years might not be an independent prognostic marker. Multicenter analyses are needed.

The Outcome of Pediatric Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: Experience from a Referral Center in South India

Although improved survival in children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL) has been demonstrated in trials, the outcome appears to be inferior in low- and middle-income countries (LMIC). Methods A file review of children aged ≤ 15 years diagnosed with Ph-ALL from 2010 to 2019 was performed. Minimal residual disease (MRD) was assessed by flow-cytometry. Real-time polymerase chain reaction (qRT-PCR) was used to quantify the BCR::ABL1 transcripts during treatment. Results The mean age of the 20 patients in the study was 91 months. Of 19 patients in whom the BCR::ABL1 transcript was confirmed, 10(50%) had P210, 7(35%) had P190, and two showed dual expression. The mean dose of imatinib that was administered was 294 ± 41 mg/m2/day. qRT-PCR for BCR::ABL1 was < 0.01% in all patients who were in remission or had a late relapse and was ≥ 0.01% in patients who had an early relapse. Two patients underwent HSCT. The 3-year event-free survival (EFS) was 35.0 ± 10.7%. Patients with a good prednisolone response (GPR) and a negative end-of-induction MRD demonstrated a superior EFS to those who lacked either or both (80.0 ± 17.9% vs. 16.7 ± 15.2%, P = 0.034). Conclusion The 3-year EFS of 20 children with Ph-ALL treated with chemotherapy and TKI was < 50%. An unusually high proportion of patients with p210 transcript expression; sub-optimal TKI dosing and lesser intensity of chemotherapy, due to the concern of high treatment-related mortality in LMIC are possible reasons for the poor outcome. Conventional treatment response parameters such as GPR and MRD predict outcomes in Ph-ALL. qRT-PCR for BCR::ABL1 may have a role in predicting early relapse.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12288-023-01684-9.

Overview on Aneuploidy in Childhood B-Cell Acute Lymphoblastic Leukemia

Recent years have brought significant progress in the treatment of B-cell acute lymphoblastic leukemia (ALL). This was influenced by both the improved schemes of conventionally used therapy, as well as the development of new forms of treatment. As a consequence, 5-year survival rates have increased and now exceed 90% in pediatric patients. For this reason, it would seem that everything has already been explored in the context of ALL. However, delving into its pathogenesis at the molecular level shows that there are many variations that still need to be analyzed in more detail. One of them is aneuploidy, which is among the most common genetic changes in B-cell ALL. It includes both hyperdiploidy and hypodiploidy. Knowledge of the genetic background is important already at the time of diagnosis, because the first of these forms of aneuploidy is characterized by a good prognosis, in contrast to the second, which is in favor of an unfavorable course. In our work, we will focus on summarizing the current state of knowledge on aneuploidy, along with an indication of all the consequences that may be correlated with it in the context of the treatment of patients with B-cell ALL.