Role of New Immunophenotypic Markers on Prognostic and Overall Survival of Acute Lymphoblastic Leukaemia – A Systematic Review and Meta-analysis

I ntroduction: Acute lymphoblastic leukaemia (ALL) is a haematologic malignancy with variable survival rates and prognosis.New immunophenotypic markers can be directly associated with prognosis in several subtypes of ALL.Methods: Following PRISMA guidelines, a systematic review of PubMed, Scopus, Science Direct, Web of Science and Cochrane Library was carried out from 2012-2016.Results: The search resulted in 23 articles, and nine of these articles met the inclusion criteria.The methodological quality was evaluated by STROBE tool that showed eight articles scoring >90%, revealing high methodological quality.The included studies evaluated 11 new immunophenotypic markers in a total of 765 patients with ALL.From these 11 markers, eight were associated with poor prognosis (CD86, CD135, CD117, CD133, CD71, CXCR4, VLA-4 and CD38+/CD58-), and three with good prognosis (CD304, CD27 and CD200).Meta-analysis demonstrated that CD71+ and absence of phenotype CD38+/CD58-in ALL have been associated to increased relapse (0.23; 95% confidence interval [CI] 0.03, 0.43), resulting in decreased overall survival (0.23; 95% CI -0.05, 0.51) at 60 months.Conclusions: CD38+/CD58-phenotype is a predictor of mortality for patients with ALL.This study reaffirmed immunophenotypic markers as independent prognostic factors that could be included into clinical protocols, risk stratification and therapeutic guidance.