Prognostic Significance of Absolute Lymphocyte Count in Pediatric Acute Lymphoblastic Leukemia

Abstract

Background: Absolute lymphocyte count (ALC) is a simple, novel, and statistically significant indicator that has been evaluated in few studies and not yet submitted as a prognostic factor in acute lymphoblastic leukemia (ALL).

Objectives: To study absolute lymphocyte count at day IS and post induction (day 42) in pediatric ALL patients, to predict its prognostic significance on outcome and to determine its role and prognostic significance in context of Minimal Residual Disease (MRD) based risk stratification.

Methods: A retrospective study of 408 pediatric ALL patients who were treated at the Children's Cancer Hospital in Egypt (CCHE) during the time period between I st of October 2007 and end of September 2009 and followed till end of September 20IO.They received ALL protocol adopted from St.Jude Children's Research Hospital (SJCRH) study XV for low and standard I high risk.

Results: A 3-year relapse free survival (RFS) and event free survival (EFS) for patients with ALC DIS with cutoff points of 350 and I500/cmm weren't statistically significant, while 3-year RFS for patients with ALC D42 <I500/cmm and ALC D42 2: ISOO/cmm were 89.3% and 91.3% respectively which was nearly significant (p=0.056). Patients with ALC D42 2: versus <I500/cmm had a 3-year EFS of 85.6% versus 84.5% (p=0.907).ALC D42 discriminated subgroups -with patients categorized