Additional cytogenetic abnormalities in adults with Philadelphia chromosome-positive acute lymphoblastic leukaemia:: a study of the Cancer and Leukaemia Group B

被引:58
作者
Wetzler, M
Dodge, RK
Mrózek, K
Stewart, CC
Carroll, AJ
Tantravahi, R
Vardiman, JW
Larson, RA
Bloomfield, CD
机构
[1] Roswell Pk Canc Inst, Dept Med, Leukemia Sect, Buffalo, NY 14263 USA
[2] Duke Univ, Med Ctr, Durham, NC USA
[3] Ohio State Univ, Ctr Comprehens Canc, Columbus, OH 43210 USA
[4] Univ Alabama Birmingham, Birmingham, AL USA
[5] Dana Farber Canc Inst, Boston, MA 02115 USA
[6] Univ Chicago, Chicago, IL 60637 USA
关键词
BCR/ABL; Philadelphia chromosome; acute lymphoblastic leukaemia; karyotype; additional aberrations; imatinib;
D O I
10.1046/j.1365-2141.2003.04736.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We analysed the nature and prognostic significance of secondary cytogenetic changes in 111 newly diagnosed adults with acute lymphoblastic leukaemia (ALL) and t(9;22)(q34;q11.2) or its variants. Secondary aberrations were seen in 75 (68%) patients. They included, in order of descending frequency: +der(22)t(9;22), +21, abnormalities of 9p, high hyperdiploidy (>50 chromosomes), +8, -7, +X and abnormalities resulting in loss of material from 8p, gain of 8q, gain of 1q and loss of 7p. Eighty patients (72%) had greater than or equal to1 normal metaphase in their karyotype. There were four balanced and 12 unbalanced translocations previously unreported in ALL with t(9;22). The t(2;7)(p11;p13) and der(18)t(8;18)(q11.2;p11.2) were seen in two cases each, and have never before been reported in haematological malignancy. All but four patients were treated on front-line Cancer and Leukaemia Group B clinical protocols. The presence of -7 as a sole secondary abnormality was associated with a lower complete remission (CR) rate (P = 0.004), while the presence of greater than or equal to3 aberrations was associated with a higher CR rate (P = 0.009) and +der(22)t(9;22) with a higher cumulative incidence of relapse (P = 0.02). It will be of interest to see if newly diagnosed t(9;22)-positive adult ALL patients with these and other secondary aberrations respond differently to treatment regimens that include imatinib mesylate.
引用
收藏
页码:275 / 288
页数:14
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