Re-Evaluate of DNA Index Among the Childhood Acute Lymphoblastic Leukemia

Abstract Background This study was aimed to re-evaluate the value of DNA index(DI) among pediatric acute lymphoblastic leukemia (ALL) with the recent chemotherapy protocols.Methods Retrospective study were analysis among pediatric ALL patients from the TAGET dataset.Result Totally, 1,668 eligible pediatric patients were enrolled in this study. Of them, 993 are male and 675 are female with a median age of 7.6 years old. The median follow-up for those patients was 7.7 years (range 0.1-15.7 years). The probability of 10-year EFS and OS were reported to be 68.3±2% and 79.6±2%, respectively. Multivariate analysis showed that DI was significantly associated with better EFS and OS. The threshold effect of DI on poor outcome was significant after adjusting for potential confounders. The adjusted regression coefficient (Log RR) was 0.7 (95%CI 0.1-3.2, P=0.597) for DI <1.1 while 8.8 (95%CI 1.4-56.0, P=0.021) for DI≥1.2 and 0.0 (95%CI 0.0-0.8, P=0.041) for 1.1≤DI<1.2. Generalized additive models revealed that the lowest rates of the adverse outcomes estimated to occur among DI between 1.1 and 1.2. Conclusion For those childhood ALL treated with recent chemotherapy protocols, the DI between 1.1 and 1.2 can serve as a significant cut-point discriminating the risk group, which indicated an independent prognostic factor.