AUTHOR=Stolpa Weronika , Mizia-Malarz Agnieszka , Zapała Magdalena , Zwiernik Bartosz TITLE=Can CD34+CD38− lymphoblasts, as likely leukemia stem cells, be a prognostic factor in B-cell precursor acute lymphoblastic leukemia in children? JOURNAL=Frontiers in Pediatrics VOLUME=11 YEAR=2023 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1213009 DOI=10.3389/fped.2023.1213009 ISSN=2296-2360 ABSTRACT=Background

CD34+CD38− lymphoblasts as likely leukemia stem cells (LSCs) may be responsible for a worse response to treatment and may be a risk factor for recurrence in B-cell precursor acute lymphoblastic leukemia (BCP-ALL).

Objective

The study objective was to assess the prognostic role of CD34+CD38− lymphoblasts in bone marrow on the day of BCP-ALL diagnosis.

Methods

115 patients with BCP-ALL, the median age of 4.5 years (range 1.5–17.9 years), gender: female 63 (54.8%) with BCP-ALL were enrolled; Group I (n = 90)—patients with CD34+CD38+ antigens and Group II (n = 20)—patients with CD34+CD38− antigens on the lymphoblast surface.

Results

A worse response on Days 8, 15, and 33 of therapy and at the end of treatment in Group II (CD34+CD38−) was more often observed but these differences were not statistically significant. A significantly higher incidence of BCP-ALL recurrence was in Group II.

Conclusions

In BCP-ALL in children, the presence of CD34+CD38− lymphoblasts at the diagnosis does not affect the first remission.

In BCP-ALL in children, the presence of CD34+CD38− lymphoblasts at the diagnosis may be considered an unfavorable prognostic factor for disease recurrence.

It is necessary to further search for prognostic factors in BCP-ALL in children.