CD20 expression has no prognostic role in Philadelphia-negative B-precursor acute lymphoblastic leukemia: new insights from the molecular study of minimal residual disease

Francesco Mannelli, Giacomo Gianfaldoni, Tamara Intermesoli, Chiara Cattaneo, Erika Borlenghi, Sergio Cortelazzo, Irene Cavattoni, Enrico Maria Pogliani, Monica Fumagalli, Emanuele Angelucci, Claudio Romani, Fabio Ciceri, Consuelo Corti, Anna Scattolin, Agostino Cortelezzi, Daniele Mattei, Ernesta Audisio, Orietta Spinelli, Elena Oldani, Alberto Bosi, Alessandro Rambaldi, Renato Bassan, Francesco Mannelli, Giacomo Gianfaldoni, Tamara Intermesoli, Chiara Cattaneo, Erika Borlenghi, Sergio Cortelazzo, Irene Cavattoni, Enrico Maria Pogliani, Monica Fumagalli, Emanuele Angelucci, Claudio Romani, Fabio Ciceri, Consuelo Corti, Anna Scattolin, Agostino Cortelezzi, Daniele Mattei, Ernesta Audisio, Orietta Spinelli, Elena Oldani, Alberto Bosi, Alessandro Rambaldi, Renato Bassan

Abstract

The prognostic significance of CD20 expression in acute lymphoblastic leukemia has been investigated in children and adults but is still a subject of debate. The aim of our study was to correlate CD20 expression with clinical-biological characteristics and outcome in 172 Philadelphia chromosome negative patients prospectively treated in a multicenter trial introducing the molecular evaluation of minimal residual disease for therapeutic purposes. We considered 20% as the threshold for CD20 positivity. Complete remission rate, minimal residual disease negativity rate at weeks 10, 16 and 22, and disease-free and overall survival were similar among CD20-positive and -negative patients, even considering minimal residual disease results and related therapeutic choices. Our study failed to demonstrate any prognostic significance for CD20 expression in Philadelphia chromosome negative acute lymphoblastic leukemia. This conclusion is supported for the first time by a comparable minimal residual disease response rate among CD20-positive and -negative and positive patients.

Trial registration: ClinicalTrials.gov NCT00358072.

Figures

Figure 1.
Figure 1.
Outline of protocol NILG-ALL 09/00, MRD study, and treatment flow in the whole cohort and according to CD20 expression. MRD-neg rate: minimal residual disease negativity rate; SCT: stem cell transplantation; rel: relapse; MRD probe(s) refers to the availability of a clonality marker.
Figure 2.
Figure 2.
(A) Overall survival and (B) disease-free survival according to CD20 status in the whole cohort. Overall survival according to CD20 status in patients resulting MRD-neg (C) and MRD-pos (D), by treatment intention. Overall survival according to CD20 status in patients resulting MRD-neg and treated with maintenance (E) or MRD-pos and receiving allogeneic SCT or high-dose therapy with autotransplantation (F). Follow-up intervals in months.

Source: PubMed

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