Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico.
Document Type
Article
Publication Date
3-1-2024
Identifier
DOI: 10.1097/MPH.0000000000002802
Abstract
Mexican and Hispanic children in Mexico and the United States, respectively, have the highest incidence and worst outcomes of pre-B acute lymphoblastic leukemia (ALL) compared with other racial/ethnic groups. Terminal deoxynucleotidyl transferase (TdT) is an intranuclear DNA polymerase normally present on immature lymphocytes (TdT-positive) and distinguishes ALL from mature lymphoid malignancies. We performed a multisite retrospective study to determine the incidence of TdT-negative precursor B-cell acute lymphoblastic leukemia (pre-B ALL) among Mexican, Caucasian, and US-born Hispanic children to correlate TdT expression with patient characteristics and known prognostic factors. Fisher exact test was performed for categorical variables and the Wilcoxon rank-sum test was used for continuous variables. TdT-negative pre-B ALL was most frequently identified in patients with National Cancer Institute high-risk disease ( P =0.014). TdT-negative expression was also most frequently associated with hypodiploid pre-B ALL ( P =0.001) and KMT2A gene rearrangement ( P =0.0012). Mexican children had the highest incidence of TdT-negative ALL compared with Caucasians and US Hispanics ( P < 0.001), with an increased incidence of poor prognostic features as well. This study demonstrates significant differences in TdT-negative expression, genomic alterations, and leukemic ploidy based on race and ethnicity.
Journal Title
Journal of pediatric hematology/oncology : official journal of the American Society of Pediatric Hematology/Oncology
Volume
46
Issue
2
First Page
131
Last Page
136
MeSH Keywords
Child; Humans; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Retrospective Studies; Mexico; Incidence; Precursor Cell Lymphoblastic Leukemia-Lymphoma; DNA Nucleotidylexotransferase; Acute Disease
Keywords
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Retrospective Studies; Mexico; Incidence; Precursor Cell Lymphoblastic Leukemia-Lymphoma; DNA Nucleotidylexotransferase; Acute Disease
Recommended Citation
Vacek M, Zárraga Vargas LC, González Domínguez E, et al. Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico. J Pediatr Hematol Oncol. 2024;46(2):e131-e136. doi:10.1097/MPH.0000000000002802
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