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

Meir Wetzler, Richard K. Dodge, Krzysztof Mrózek, Carleton C. Stewart, Andrew J. Carroll, Ramana Tantravahi, James W. Vardiman, Richard A. Larson, Clara D. Bloomfield

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

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 ≥1 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 ≥3 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.

Original languageEnglish
Pages (from-to)275-288
Number of pages14
JournalBritish Journal of Haematology
Volume124
Issue number3
DOIs
StatePublished - Feb 2004
Externally publishedYes

Keywords

  • Acute lymphoblastic leukaemia
  • Additional aberrations
  • BCR/ABL
  • Imatinib
  • Karyotype
  • Philadelphia chromosome

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