Background: Anaplastic large cell lymphoma (ALCL) constitutes 10-15% of childhood non-Hodgkin lymphoma. Despite different treatment strategies, event-free survival has remained stable. CD3 expression, a T-cell marker, can be lost or diminished in some ALCL cases, which may affect the prognosis, especially in relapse settings according to some studies. The purpose of this study is to determine the effect of CD3 expression on survival and its relation to the other prognostic variables in pediatric ALCL.
Methods: A retrospective analytical study was conducted on 89 newly diagnosed pediatric ALCL patients (under 18 years old) treated at Children's Cancer Hospital Egypt (CCHE-57357) from July 2007 to December 2019. Immunohistochemistry was utilized to confirm the diagnosis and determine CD3 expression in tumor cells. Survival results - event-free survival (EFS), relapse-free survival (RFS), and overall survival (OS) - were analyzed concerning CD3 expression and other risk factors.
Results: The median age was 10.7 years with a male-to-female ratio of 1.8-1. The majority of patients (85.4%) were ALK positive. CD3 was positive in 31 (34.8%) patients. The median follow-up period was 60 months. The five-year OS, EFS and RFS rates for the entire group were 84.3%, 73.1%, and 81.5%, respectively. CD3 positivity was linked to more central nervous system (CNS) involvement (p=0.03) but did not significantly correlated with other patient features or survival outcomes.
Conclusion: This study indicates that CD3 expression may not affect the survival in newly diagnosed pediatric ALCL. However, stage, B symptoms, and particular organ involvement were linked to lower relapse-free survival. Additional studies are needed to validate these findings in larger cohorts.
No relevant conflicts of interest to declare.
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