Abstract

Background: Immunophenotyping has been implemented in the diagnosis of children with acute leukemia in Yogyakarta, Indonesia. The aim of this study was to determine whether expression of CD10 and/or CD34 could be used as additional prognostic markers for children with acute lymphoblastic leukemia (ALL) treated on the Indonesia ALL 2006 protocol.

Materials & Methods: Of 211 ALL patients immunophenotype was determined and related to clinical data. Patient outcome was calculated as overall survival and event free survival, in which events were defined as: induction failure, death, abandonment, or relapse.

Results: In the overall patients cohort, combination of CD10 and/or CD34 expression is an independent favorable prognostic factor in both univariate and multivariate analyses. In B-lineage ALL expression of CD10, CD34 and CD10⁺ and/or CD34⁺ were: 78%, 59% and 90% respectively. Although CD10, CD34 and the combined expression were associated with favorable outcome in the overall cohort, none of these parameters remained a significant independent risk factor after multivariate analysis in B-lineage leukemia. In T-lineage leukemia, expressions of CD10, CD34 and CD10⁺ and/or CD34⁺ were: 30%, 21% and 49% respectively. Co-expression of CD10 and/or CD34 in this subgroup was a significant favorable prognostic factor in both univariate and multivariate analysis.

Conclusion: In our Indonesian population CD10 expression alone and in combination with CD34 expression are prognostically significant positive parameters.

Keywords: immunophenoyping, childhood leukemia, Acute Lymphoblastic Leukemia, CD10 , CD34, clinical outcome, Indonesia, developing country, Yogyakarta