ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1569370
Impact of CD3 Expression on Outcome in Pediatric Anaplastic Large Cell Lymphoma
Provisionally accepted
Ahmed Obeid1*
Samah Semary1*
Hanafy Hafez2
Eman Nageb1Sonia Soliman1Iman Zaky1
Shahenda Mahmoud1
Leslie Lehmann3
Alaa Elhaddad1- 1Children Cancer Hospital, Cairo, Egypt
- 2National Cancer Institute, Cairo University, Cairo, Beni Suef, Egypt
- 3Dana–Farber Cancer Institute, Boston, Massachusetts, United States
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Background: Anaplastic large cell lymphoma (ALCL) constitutes 10-15% of childhood non-Hodgkin lymphoma. EFS is 70% and currently 80% with the additional of targeted agents such as CD30 directed conjugated monoclonal antibody brentuximab or ALK inhibitors such as crizotinib. Expression of CD3, a T-cell marker, can be lost or diminished in some ALCL cases. The literature is conflicting on whether CD3 expression affects prognosis, and it has been analyzed mostly in the relapse setting. The purpose of this study was to determine the effect of CD3 expression on survival and its relation to the other prognostic variables in newly diagnosed patients with pediatric ALCL treated at a single large pediatric oncology center.Methods: A retrospective study was done 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. The impact of CD3 expression on event-free survival (EFS), relapsefree survival (RFS) and overall survival (OS)) was analyzed.The median age was 10.7 years with male to female ratio 1.8:1. The majority of patients (85.4%) were ALK positive. CD3 was positive in 31 (34.8%) of 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 associated with a higher incidence of CNS involvement (p=0.03) but did not significantly impact other patient outcomes (EFS, RFS and OS).However, stage, B symptoms, and skin involvement were linked to a shorter relapse-free survival.This study indicates that CD3 expression may not be a major factor predicting survival in newly diagnosed pediatric ALCL. Additional research is needed to understand its association with CNS positive disease.
Keywords: CD3, Survival, Pediatric Anaplastic Large Cell Lymphoma, ALK, Outcome
Received: 03 Feb 2025; Accepted: 22 Apr 2025.
Copyright: © 2025 Obeid, Semary, Hafez, Nageb, Soliman, Zaky, Mahmoud, Lehmann and Elhaddad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ahmed Obeid, Children Cancer Hospital, Cairo, Egypt
Samah Semary, Children Cancer Hospital, Cairo, Egypt
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