Prognostic factors and outcomes of infant acute lymphoblastic leukemia (ALL), hypodiploid ALL, and mixed-phenotype acute leukemia (MPAL) in Canada: a report from CYP-C

• Published in: Leukemia & lymphoma 2022-11, Vol.63 (13), p.3208-3216
• Main Authors: Tibout, Pauline, Ledjiar, Omar, Athale, Uma, Rayar, Meera, Kulkarni, Ketan, Truong, Tony, Cellot, Sonia, Bittencourt, Henrique, Pelland-Marcotte, Marie-Claude, Tran, Thai Hoa
• Format: Article
• Language: English
• Subjects: Acute Disease; Humans; hypodiploid; Infant acute lymphoblastic leukemia; mixed phenotype acute leukemia; Phenotype; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Prognosis; Retrospective Studies
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2022.2118536

The epidemiology of infant acute lymphoblastic leukemia (ALL), hypodiploid ALL, and mixed-phenotype acute leukemia (MPAL) in Canada is unknown. The main objective was to describe the prevalence, prognostic factors, and outcomes of three rare and high-risk ALL subtypes in Canada. This is a retrospective study using the Cancer in Young People-Canada (CYP-C) database. Event-free survival (EFS) and overall survival (OS) were described by the Kaplan-Meier method and compared using the log-rank test. Among 2626 children aged 0-14 years diagnosed with B-cell acute lymphoblastic leukemia (B-ALL) between 2001 and 2018, 227 (8.6%) patients were identified to be infant ALL (n = 139), hypodiploid ALL (n = 43), or MPAL (n = 45). The 5-year EFS/OS was significantly worse in the infant ALL subgroup compared to that of hypodiploid ALL and MPAL. For the entire cohort, presenting White blood cells (WBCs) ≥50 × 10 9 /L was independently associated with worse EFS/OS.