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Blood, 18 June 2009, Vol. 113, No. 25, pp. 6330-6337. Prepublished online as a Blood First Edition Paper on August 14, 2008; DOI 10.1182/blood-2008-04-151860. This Article Full Text Full Text (PDF) Supplemental Table All Versions of this Article: blood-2008-04-151860v1 113/25/6330    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Thomas, D. A. Articles by Kantarjian, H. M. Search for Related Content PubMed PubMed Citation Articles by Thomas, D. A. Articles by Kantarjian, H. M. Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Prognostic significance of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemia Deborah A. Thomas1, Susan O'Brien1, Jeffrey L. Jorgensen2, Jorge Cortes1, Stefan Faderl1, Guillermo Garcia-Manero1, Srdan Verstovsek1, Charles Koller1, Sherry Pierce1, Yang Huh2, William Wierda1, Michael J. Keating1, and Hagop M. Kantarjian1 Departments of 1 Leukemia and 2 Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston Immunophenotypic classification of acute lymphoblastic leukemia (ALL) has well-recognized prognostic implications. The significance of CD20 expression has been evaluated in childhood precursor B-lineage ALL with conflicting results. We retrospectively analyzed the influence of CD20 expression on outcome in 253 adults with de novo precursor B-lineage ALL treated with either conventional (VAD/CVAD) or intensive (hyper-CVAD) frontline chemotherapy regimens in the pre-rituximab era. Overall, CD20 positivity of at least 20% was associated with lower 3-year rates of complete remission duration (CRD; 20% vs 55%, P < .001) and overall survival (OS; 27% vs 40%, p = .03). In the CD20 negative subset, the 3-year rates for CRD (58% vs 42%, p = .04) and OS (60% vs 28%, P < .001) were superior for hyper-CVAD compared with VAD/CVAD; rates were particularly favorable for the CD20 negative younger age group (68% and 85%, respectively). In contrast, 3-year CRD and OS rates were uniformly poor for the CD20-positive group regardless of therapy (27% or less). Multivariate analysis for event-free survival identified older age, leukocyte count higher than 30 x 109/L, presence of Philadelphia chromosome, high systemic risk classification, and CD20 positivity as independent predictors of worse outcome. In conclusion, CD20 expression in de novo adult precursor B-lineage ALL appears to be associated with a poor prognosis. Incorporation of monoclonal antibodies directed against CD20 into frontline chemotherapy regimens warrants investigation. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Maury, F. Huguet, T. Leguay, F. Lacombe, M. Maynadie, S. Girard, A. de Labarthe, E. Kuhlein, E. Raffoux, X. Thomas, et al. Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia Haematologica, February 1, 2010; 95(2): 324 - 328. [Abstract] [Full Text] [PDF] M. R. Litzow Evolving paradigms in the therapy of Philadelphia chromosome-negative acute lymphoblastic leukemia in adults Hematology, January 1, 2009; 2009(1): 362 - 370. [Abstract] [Full Text] [PDF]

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