Clinicopathological impact of CD20 expression in childhood B cell precursor acute lymphoblastic leukemia (BCP-ALL)

Abstract

Recognition of BCR/ABL translocation is obligatory in precursor B cell precursor acute lymphoblastic leukemia (BCP-ALL) patients at diagnosis for categorization of patients. The risk stratification of BCP-ALL especially those negative for Philadelphia chromosome is an area of research. The prognostic impact of CD20 expression in childhood BCP-ALL remains controversial. In pediatric patients with BCP-ALL, some studies have demonstrated that CD20 overexpression correlates with bad overall survival, but some others suggest a better outcome. This study aimed to evaluate the efficacy of CD20 expression as a biological marker in BCP-ALL. For 104 children with newly diagnosed BCP-ALL included in this study, CD20 expression was evaluated by flow cytometry. CD20 was positively expressed in 40 (38.5%) of cases. The CD20^positive subgroup had significantly shorter overall survival and disease free survival as compared to the CD20^negative one (P = 0.018; <0.001, respectively). Combined positivity for CD20 and Philadelphia chromosome was detected in 16/40 of studied cases. This patient group had the poorest overall survival and the shortest disease-free survival. In conclusion, CD20 expression at diagnosis in BCP-ALL is a useful biomarker for risk stratification and subsequently in treatment decision especially in Philadelphia negative BCP-ALL.

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