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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 (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 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 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  |  Next Article  Submitted April 24, 2008 Accepted July 16, 2008 Prognostic significance of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemia Deborah A Thomas*, Susan O'Brien, Jeffrey L Jorgensen, Jorge Cortes, Stefan Faderl, Guillermo Garcia-Manero, Srdan Verstovsek, Charles Koller, Sherry Pierce, Yang Huh, William Wierda, Michael J Keating, and Hagop M Kantarjian Division of Cancer Medicine, Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, TX, United States Division of Pathology and Laboratory Medicine, Department of Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston, TX, United States * Corresponding author; email: debthomas{at}mdanderson.org. 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 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 favourable 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 > 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?

	Copyright © 2008 by American Society of Hematology         Online ISSN: 1528-0020