Significance of CD34-Positive Cells in Children with B-Cell Acute Lymphoblastic Leukemia: A Case-Control Study

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer among children. The prognostic significance of the cluster of differentiation 34 (CD34) markers in children with B-cell acute lymphoblastic leukemia (B-ALL) is not yet fully understood. Materials and Methods: This study is a case-control trial based on the clinical data of 40 children with B-ALL who referred to a pediatric oncology center in the city of Sari, Iran. The data were derived from the demographic findings, laboratory test results at diagnosis, immunophenotyping, transfusion of blood products including packed red blood cells and platelet concentrates, and the frequency and duration of hospitalization due to febrile infection. Results: Of the participants, 42.5% were CD34-negative and 57.5% were CD34-positive. The mean age of the patients at diagnosis was 3.1 ± 3.3 years (Range:0.1-13.3 years). Also, 60.9% of the CD34-positive children and 47.1% of the CD34-negative ones were boys (P = 0.38). According to the calculated Cohen's d, the relationship of CD34 positivity with transfused packed red blood cell and platelet concentrates was mild -0.15 (95% CI -0.78 to 0.47) (P = 0.55) and moderate 0.49 (95% CI -0.15 to 1.12) (P = 0.29), respectively, which was significant in neither case. Moreover, the relationship of CD34 positivity with the hospitalization frequency of -0.51 (95% CI -1.14 to 0.13) (P = 0.22) and the hospitalization duration of -0.52 (95% CI -1.16 to 0.12) (P = 0.27) due to febrile infection was moderate to strong. Conclusion: The CD34-positive children with B-ALL experienced less blood products transfusion (except packed red blood cells) and febrile infection in terms of both the frequency and duration of hospitalization during chemotherapy. Therefore, CD34 expression in the B-ALL children was associated with better prognosis.