Haematologica (Feb 2010)

Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia

  • Sébastien Maury,
  • Françoise Huguet,
  • Thibaut Leguay,
  • Francis Lacombe,
  • Marc Maynadié,
  • Sandrine Girard,
  • Adrienne de Labarthe,
  • Emilienne Kuhlein,
  • Emmanuel Raffoux,
  • Xavier Thomas,
  • Patrice Chevallier,
  • Agnès Buzyn,
  • André Delannoy,
  • Yves Chalandon,
  • Jean-Paul Vernant,
  • Philippe Rousselot,
  • Elizabeth Macintyre,
  • Norbert Ifrah,
  • Hervé Dombret,
  • Marie-Christine Béné

DOI
https://doi.org/10.3324/haematol.2009.010306
Journal volume & issue
Vol. 95, no. 2

Abstract

Read online

The prognostic significance of CD20 expression in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has been mostly studied in children and yielded conflicting results. In 143 adults with Philadelphia chromosome-negative BCP-ALL treated in the multicentric GRAALL 2003 trial, CD20 positivity over 20% was observed in 32% of patients. While not influencing complete remission achievement, CD20 expression was associated with a higher cumulative incidence of relapse (CIR) at 42 months (P=0.04), independently of the ALL high-risk subset (P=0.025). Notably, the negative impact of CD20 expression on CIR was only observed in patients with a white blood cell count (WBC) over 30×109/L (P=0.006), while not in those with a lower WBC. In the former subgroup, this impact translated into lower event-free survival (15% vs. 59% at 42 months, P=0.003). CD20 expression thus appears to be associated with a worse outcome, which reinforces the interest of evaluating rituximab combined to chemotherapy in CD20-positive adult BCP-ALL. ClinicalTrials.gov ID, NCT00222027.