Clinical Analysis Of 19 BCR-ABL Positive Childhood Acute Lymphoblastic Leukemia

Objective To study the clinical characteristics and outcomes of BCR-ABL positive acute lymphoblastic leukemia(ALL) in children, To evaluate the application of tyrosine kinase inhibitor(TKI) for the clinical therapeutic value. Methods A retrospective analysis of the clinical data of 19 patients aged less than 15 years when first diagnosed with BCR-ABL positive ALL from October 1, 2008 to January 31,2016, They were treated either by Chinese Childhood Leukemia Group ALL 2008(CCLG-ALL2008) or by Chinese Childhood Cancer Group ALL 2015(CCCG-ALL2015) protocol combined with or without TKI. Results Most of BCR-ABL positive ALL patients had older age, hepatomegaly, splenomegaly,lymphadenopathy, and a high white blood cell count when first diagnosed, bone marrow immune phenotype was mainly B-based, the overall survival was poor.Compare the prognosis of 9 patients treated with imatinib or dasatinib with 9 cases did not, 3-year overall survival(OS) was 85.7% and 22.2%, with a significant difference(P = 0.005), 2-year event free survival( EFS) was 64.2% vs 11.1%(P =0.015). Conclusion BCR-ABL positive ALL children patients have a poor prognosis,the application of TKI can significantly improve the clinical efficacy in this subgroup of children. But how to choose the suitable kind of TKI, whether transplant is still needed or the therapy of TKI is still needed after transplant, we need large sample of clinical data to prove that.