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Absence of biallelic TCR γ deletion predicts induction failure and poorer outcomes in childhood T‐cell acute lymphoblastic leukemia
Author(s) -
Yang YungLi,
Hsiao ChihCheng,
Chen HsuanYu,
Lin KaiHsin,
Jou ShiannTarng,
Chen JiannShiuh,
Chang TeKau,
Sheen JiunnMing,
Yu SungLiang,
Lu MengYao,
Cheng ChaoNeng,
Wu KangHsi,
Wang ShihChung,
Wang JiaanDer,
Chang HsiuHao,
Lin ShuRung,
Lin ShuWha,
Lin DongTsamn
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24021
Subject(s) - medicine , hazard ratio , t cell receptor , confidence interval , proportional hazards model , multivariate analysis , oncology , asparaginase , t cell , induction chemotherapy , immunology , chemotherapy , leukemia , gastroenterology , lymphoblastic leukemia , immune system
Background The absence of biallelic TCR γ deletion (ABD) is a characteristic of early thymocyte precursors before V(D)J recombination. The ABD was reported to predict early treatment failure in T‐cell acute lymphoblastic leukemia (ALL). This study aimed to investigate its prognostic value in Taiwanese patients with T‐cell ALL. Procedure Forty‐five children with T‐cell ALL were enrolled from six medical centers in Taiwan. Quantitative DNA polymerase chain reaction (Q‐PCR) was performed to check the status of TCR γ deletion. The threshold for homozygous deletions by Q‐PCR was defined as a fold‐change <0.35. Results ABD was found in 20 patients [20:45] who had higher incidences of induction failure than those without ABD ( P = 0.03; hazard ratio [HR] = 8.13; 95% confidence interval [95% CI] = 1.23–53.77) after multivariate regression analysis. Patents with ABD also had inferior EFS and OS ( P = 0.071 and 0.0196, respectively). Multivariate Cox analysis indicated that the association between ABD and overall survival was independent of age and leukocyte count on presentation ( P = 0.036; HR = 4.25; 95% CI = 1.10–16.42). Conclusions The absence of TCR γ deletion is a predictor of a poor response to induction chemotherapy for pediatric patients with T‐cell ALL in Taiwan. Providing patients with T‐cell ALL and ABD with alternative regimens may be worthwhile to test in future clinical trials. Pediatr Blood Cancer 2012; 58: 846–851. © 2011 Wiley Periodicals, Inc.