Abstract |
Multiple cytogenetic subgroups have been described in adult Philadelphia chromosome (Ph)-negative B-cell precursor (BCP) acute lymphoblastic leukemia (ALL), often comprising small numbers of patients. In this study, we aimed to reassess the prognostic value of cytogenetic abnormalities in a large series of 617 adult patients with Ph-negative BCP-ALL (median age, 38 years), treated in the intensified Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-2003/2005 trials. Combined data from karyotype, DNA index, fluorescence in situ hybridization, and polymerase chain reaction screening for relevant abnormalities were centrally reviewed and were informative in 542 cases (88%), allowing classification in 10 exclusive primary cytogenetic subgroups and in secondary subgroups, including complex and monosomal karyotypes. Prognostic analyses focused on cumulative incidence of failure (including primary refractoriness and relapse), event-free survival, and overall survival. Only 2 subgroups, namely t(4;11)/KMT2A-AFF1 and 14q32/IGH translocations, displayed a significantly worse outcome in this context, still observed after adjustment for age and after censoring patients who received allogeneic stem cell transplantation (SCT) in first remission at SCT time. A worse outcome was also observed in patients with low hypodiploidy/near triploidy, but this was likely related to their higher age and worse tolerance to therapy. The other cytogenetic abnormalities, including complex and monosomal karyotypes, had no prognostic value in these intensive protocols designed for adult patients up to the age of 60 years.
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Authors | Marina Lafage-Pochitaloff, Laurence Baranger, Mathilde Hunault, Wendy Cuccuini, Christine Lefebvre, Audrey Bidet, Isabelle Tigaud, Virginie Eclache, Eric Delabesse, Chrystèle Bilhou-Nabéra, Christine Terré, Elise Chapiro, Nathalie Gachard, Marie-Joelle Mozziconacci, Geneviève Ameye, Sarah Porter, Nathalie Grardel, Marie C Béné, Yves Chalandon, Carlos Graux, Françoise Huguet, Véronique Lhéritier, Norbert Ifrah, Hervé Dombret, Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) |
Journal | Blood
(Blood)
Vol. 130
Issue 16
Pg. 1832-1844
(10 19 2017)
ISSN: 1528-0020 [Electronic] United States |
PMID | 28790105
(Publication Type: Journal Article)
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Copyright | © 2017 by The American Society of Hematology. |
Topics |
- Adolescent
- Adult
- Chromosome Aberrations
(statistics & numerical data)
- Clinical Trials as Topic
(statistics & numerical data)
- Cytogenetic Analysis
- Female
- Humans
- Karyotyping
- Male
- Middle Aged
- Multicenter Studies as Topic
(statistics & numerical data)
- Philadelphia Chromosome
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
(diagnosis, epidemiology, genetics, therapy)
- Predictive Value of Tests
- Prognosis
- Retrospective Studies
- Young Adult
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