Cytogenetics adds independent prognostic information in adults with acute lymphoblastic leukaemia on MRC trial UKALL XA

Secker-Walker, LM; Prentice, HG; Durrant, Jill; Richards, Susan; Hall, Emma; Harrison, Gill

doi:10.1046/j.1365-2141.1997.d01-2053.x

Cited by 221 publications

(163 citation statements)

References 17 publications

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“…20,21 Recently, TEL/AML1 translocation was identified in childhood ALL and was deemed relevant to prognosis. 22,23 TEL/AML1 translocation is exclusively expressed in ALL patients between 1 and 5 years of age and decreases with age.…”

Section: Figurementioning

confidence: 99%

Clinicopathologic characteristics of leukemia in Japanese children and young adults

2001

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The aim of this study is to clarify the clinicopathologic characteristics of adolescent leukemia in Japan by retrospective analysis. Patients with acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), and myelodysplastic syndrome (MDS), consecutively diagnosed from 1986 to 1999, were enrolled. A total of 3856 patients from 1 to 15 years of age and 1803 patients from 15 to 29 years of age were eligible for this study. Demographically, the frequency of AML found was almost constant during the teenage years, whereas the frequency of ALL gradually decreased. The relative frequency of CML and MDS apparently started to increase in patients in their late teens. The relative frequency of M3 and t(15;17) gradually increased during adolescence. Among patients aged 1 to 4 years, M7 was the most frequent FAB subtype. Among patients aged 5 to 9 years, M2 and t(8;21) was the most frequent subtype. The percentage of T cell ALL increased in patients 5 to 9 years old, reaching 31.2% in the 20-to 24-year-old age group. The percentage of patients with hyperdiploidy over 50 chromosomes was highest (17.0%) in patients aged 1 to 4 and decreased to 3.9% in the older teens. The percentage of patients with the Ph 1 chromosome increased from 9.9% in teens to 30.0% in patients in their late twenties. When comparing event-free survival (EFS) rates for ALL according to age, the estimated 7-year EFS rate was highest for patients aged 1 to 9 years (65.9%) and intermediate for patients aged 10 to 15 years (48.4%). However, the EFS rate was significantly worse for patients aged 15 to 19 years (19.4%) and 20 to 29 years (17.0%) (P = 0.024). On the other hand, the EFS rate for AML decreased with increasing age, although without statistical significance. The overall survival rates are approximate among all age groups. The results of the study indicate that there are considerable variations in biologic features of leukemia between children and young adults. The prognosis for adolescent leukemia may be improved by introducing pediatric trials, which take into account the prognostic biological features. Leukemia (2001Leukemia ( ) 15, 1256Leukemia ( -1261

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Section: Figurementioning

confidence: 99%

Clinicopathologic characteristics of leukemia in Japanese children and young adults

2001

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“…[28][29][30] In this study, only one case showed Philadelphia chromosome among seven karyotyped ALLm cases. Although the number of cases was limited, this result means ALLm is an independent morphologic variant not related to any cytogenetic aberrations.…”

Section: Discussionmentioning

confidence: 94%

Acute lymphoblastic leukemia with maturation–a new entity with clinical significance

Kim

et al. 1998

Leukemia

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“…1,2,4 BMT from a sibling donor is a more effective treatment with 2-year DFS probabilities of 38 and 46% for patients in 1st CR and 41 and 28% for patients beyond 1st CR in the IBMTR series 5 and the series reported by Chao et al 6 Radich et al 7 reported 30 patients who received BMT in CR or relapse, of whom nine were disease-free beyond 2 years. Casper et al 8 reported 68% DFS at 13 months in 14 paediatric patients who received BMT in CR.…”

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FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission

Deane

Koh

Foroni

et al. 1998

Bone Marrow Transplant

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Summary:We describe a single centre experience of eight consecutive patients with relapsed or refractory Ph + ALL treated with the FLAG/idarubicin regimen followed by BMT or PBSCT. Following FLAG/idarubicin, one achieved a partial response and seven CR. All patients subsequently received allogeneic transplants: one sibling BMT, three matched unrelated (MUD) BMT and four sibling PBSCT. Two patients received second transplants with PBSC from their original BM donors following FLA/Ida with no further conditioning. Three patients are alive in CR 9, 24 and 32 months after transplant. Seven of eight patients had a cytogenetic response following FLAG/Ida induction and one of seven became bcr-abl negative. All eight patients had a complete cytogenetic response following transplant. Four of five assessable patients became p190 bcr-abl negative after transplant; three of these subsequently relapsed. Both patients with the p210 bcr-abl transcript remained bcrabl positive in CR after transplant. FLAG/Ida was well tolerated and appears to be effective in inducing remission in relapsed Ph + ALL. The use of FDR-containing chemotherapy without further conditioning prior to PBSCT deserves further study in heavily pretreated patients and, in patients with relapsed ALL following BMT, may be a safer option than DLI (donor lymphocyte infusion) by avoiding the associated risk of aplasia. Keywords: fludarabine; FLAG; acute lymphoblastic leukaemia; Philadelphia chromosome; bcr-abl; peripheral blood stem cell transplantation The Ph chromosome, t(9;22)(q34;q11), is detected in up to 25% of adults and in 2-6% of children with ALL and the bcr-abl transcript is detectable by PCR in up to 32% of adults with ALL. 1,2 Most childhood and more than 50% of adult Ph + ALL express the p190 rather than the p210 bcrabl fusion transcript. 3 The prognosis with chemotherapy alone is very poor with almost no long-term survivors, Correspondence: Dr M Deane, Department of Haematology, Norfolk and Norwich Hospital, Brunswick Road, Norwich, NR1 3SR, UK Received 22 April 1998; accepted 30 July 1998 median CR duration of 7 months and 13% 3-year diseasefree survival (DFS) probability in adults. 1,2,4 BMT from a sibling donor is a more effective treatment with 2-year DFS probabilities of 38 and 46% for patients in 1st CR and 41 and 28% for patients beyond 1st CR in the IBMTR series 5 and the series reported by Chao et al. 6 Radich et al 7 reported 30 patients who received BMT in CR or relapse, of whom nine were disease-free beyond 2 years. Casper et al 8 reported 68% DFS at 13 months in 14 paediatric patients who received BMT in CR.The results of chemotherapy in patients with relapsed acute leukaemia after BMT are poor especially in those who relapse early. 9 Second BMT is associated with a high mortality and morbidity especially when performed within 1 year of the initial transplant with only 10% long-term survivors in the IBMTR series. [10][11][12] The role of DLI as adoptive immunotherapy for relapsed CML after BMT has been established in recent years. [13][1...

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Cytogenetics adds independent prognostic information in adults with acute lymphoblastic leukaemia on MRC trial UKALL XA

Cited by 221 publications

References 17 publications

Clinicopathologic characteristics of leukemia in Japanese children and young adults

Clinicopathologic characteristics of leukemia in Japanese children and young adults

Acute lymphoblastic leukemia with maturation–a new entity with clinical significance

FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission

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