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Additional cytogenetic abnormalities in adults with Philadelphia chromosome‐positive acute lymphoblastic leukaemia: a study of the Cancer and Leukaemia Group B
Author(s) -
Wetzler Meir,
Dodge Richard K.,
Mrózek Krzysztof,
Stewart Carleton C.,
Carroll Andrew J.,
Tantravahi Ramana,
Vardiman James W.,
Larson Richard A.,
Bloomfield Clara D.
Publication year - 2004
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2003.04736.x
Subject(s) - imatinib mesylate , karyotype , medicine , cancer , malignancy , gastroenterology , cumulative incidence , incidence (geometry) , chromosomal translocation , cytogenetics , oncology , imatinib , chromosome , biology , genetics , cohort , physics , myeloid leukemia , optics , gene
Summary 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.