Evidence map›Paper›PMID 39609281›Full record

ArticleAnnals of hematology2024

Clonal evolution defines risk stratification for central nervous system leukemia in adult acute lymphoblastic leukemia.

Jia Li, Junjie Chen, Qiang Wang, Jiawang Ou, Zicong Huang, Shiyu Deng, Jieping Lin, Zihong Cai, Qifa Liu, HongSheng Zhou

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Article in Annals of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Jia Li *Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Junjie Chen *Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Qiang WangDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Jiawang OuDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Zicong HuangDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Shiyu DengDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Jieping LinDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Zihong CaiDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Qifa LiuDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
HongSheng ZhouDepartment of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China. hanson_tcm@126.com.

Funding

Beijing Xisike Clinical Oncology Research Foundation CHIPSCREENClinical Trial Funding of Nanfang Hospital 2023CR009National Natural Science Foundation of China NSFC82170163Science and Technology Planning Project of Guangdong Province 2017A030313601
6 · The paper itself

Abstract

It is well established that central nervous system leukemia (CNSL) is an adverse prognostic factor in acute lymphoblastic leukemia (ALL), yet whether prognostic heterogeneity reside in CNSL is less addressed. Therefore, we aimed to develop potential risk classification for CNSL. We retrospectively analyzed a study in PDT-ALL-2016 pediatric-inspired cohort (N = 494). Flow cytometry (FCM) and next-generation sequencing (NGS) were tested on bone marrow (BM) and cerebrospinal fluid (CSF). The 5-year OS of 437 non-CNSL patients was 62.3% and 33.7% in 57 CNSL patients (P < 0.001). 57 CNSL including 16 primary CNS involvement and 41 CNS relapse patients were divided into 3 groups. The 5-year OS was 48.9% in patients with concordant FCM and NGS between BM and CSF, which were defined as non-clonal evolutionary CNSL, a standard-risk subgroup, while the 5-year OS was 30.2% in patients with discordant FCM or NGS between BM and CSF and isolated CNS relapse (P < 0.05), which were defined as clonal evolutionary CNSL, a high-risk subgroup. Furthermore, the mean times of lumbar punctures to achieve complete remission (CR) in CSF was 4.14 in clonal evolutionary CNSL, comparing to 1.62 in non-clonal evolutionary CNSL (P < 0.05). Based on the evidence of clonal evolution, we develop a risk stratification for CNSL for the first time.

Indexed as

Central Nervous System NeoplasmsClonal EvolutionPrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentAdultAgedFemaleFlow CytometryHigh-Throughput Nucleotide SequencingHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentYoung AdultCentral nervous system leukemiaClone evolutionNext generation sequenceRisk stratification

Identifiers

PMID39609281

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.