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Immunophenotype of adult acute lymphoblastic leukemia, clinical parameters,
and outcome: an analysis of a prospective trial including 562 tested
patients (LALA87). French Group on Therapy for Adult Acute Lymphoblastic
Leukemia
C Boucheix, B David, C Sebban, E Racadot, MC Bene, A Bernard, L Campos, H Jouault, F Sigaux and E Lepage
Hopital Paul-Brousse, Institut National de la Sante et de la Recherche
Medicale, Unite 268, Villejuif, France.
The aim of the multicentric trial LALA87 was to test the efficacy of
different postremission therapies in adults (15 to 60 year olds) with acute
lymphoblastic leukemia (ALL). An immunologic subclassification based on
surface marker expression was proposed. Among the 562 tested patients, 511
were assigned either to the B lineage (361 cases, 63%) or to the T lineage
(150 cases, 26%). T-ALL were significantly associated with male sex, age
less than 35 years, mediastinal mass, central nervous system involvement,
high white blood cell count, and low anemia. In a univariate and
multivariate analysis, T-cell leukemia had a more favorable outcome than
B-cell leukemia with respective median disease-free survivals (DFSs) of 28
and 14 months (P < .005). However, the type of postremission therapy
modifies the value of the immunophenotype prognostic factor. In the
chemotherapy arm, T-ALL patients (26 patients) had a more favorable outcome
than B-ALL patients (57 patients) (P < .003). In the autologous bone
marrow transplantation (ABMT) arm, the apparent better outcome of T-ALL
patients (35 T/50 B) did not reach statistical significance (P = .2) and
there was no difference in the allogeneic bone marrow transplantation
(alloBMT) arm (37 T/71 B: P = .9). In the B-cell-lineage leukemias,
subclassification by stages and myeloid antigen coexpression (10%) were not
associated with different prognosis. CD10+ T-ALL (31 patients) were
associated with a better DFS compared with the CD10- T-ALL (73 patients)
with respective median DFS, not reached and 18.5 months (P = .04).
Volume 84,
Issue 5,
pp. 1603-1612,
09/01/1994
Copyright © 1994 by The American Society of Hematology
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