Influence of detection of pretreatment cytogenetic abnormalities on first complete remission and survival in adult acute lymphoblastic leukemia

Abstract

Objective: Treatment of acute lymphoblastic leukemia (ALL) in adults focuses on the initial assessment of the prognostic relevant cytogenetic features as well as a response-guided therapy based on molecular data. We examined the importance of molecular-cytogenetic abnormalities for complete remission (CR) rates and the overall survival (OS) in adult ALLs. Materials and Methods: Conventional cytogenetics and fluorescence in situ hybridization were performed on bone marrow cells from 33 newly-diagnosed ALL adults. Two karyotype categories [standard-risk group-normal karyotype, hyperdiplody and other structural aberrations, and high-risk group-t(11q23)/MLL, t(9;22)/bcr-abl, t(1;19), t(8;14), C-MYC and complex karyotype] and the biologically and clinically relevant ALL ploidy subgroups were prospectively defined. Results: Chromosomal abnormalities were found in 52% of the cases with a high rate of poor-risk translocations -t(9;22), t(8q24), t(11q23), t(1;19). The total CR rate was 67% and the median time for achievement 2.33 months. Male sex, an age below 35 years and the absence of high risk translocations might have contributed to the high CR rates. Female patients, hyperdiplody, low white blood cells (WBC), and random cytogenetic aberrations had the longest OS. OS, 3-and 5-years survival periods were significantly shorter for poor-risk than standard risk group (p=.015, p=.001 and p=.005, respectively). Conclusion: This study emphasizes the lack of influence of cytogenetic aberrations on the CR and the time to achieve CR. However, our observations show that these aberrations are an independent prognostic factor in adult ALL -they allow predicting therapy resistance and the OS time after intense treatment. (Turk J Hematol 2011; 28: 176-85)

Association of the Presence of BCR-Abl1 Gene Rearrangements and Myeloid Aberrant Antigens in Precursor B-Acute Lymphoblastic Leukemia (Pre-B-All) Patients

“…comparatively more than that reported in literature. Our results were similar to the results of another study by Raza et al [18], in which the reported incidence was 85.4%, while our results were in contrast to few other studies conducted in Bangladesh [23], Pakistan [17,19], Turkey [21], Guatemala [22] and India [20] which reported relatively lower incidence.…”

Treatment outcomes of pediatrics acute myeloid leukemia (AML) and associated factors in the country’s tertiary referral hospital, Ethiopia

“…The FAB subtype can predict the outcome of patients with AML, with FAB-M2 and FAB-M3 showing relatively better outcomes. The median survival time for the FAB-M3 category was not calculated as less than 50% of events (deaths) occurred by the end of the study period [33,34]. However, this is in contrast to the report by Walter et al, in which the morphological subclassification of AML did not show significant prognostic information for cases of AML [35].…”

“…The substantially inferior treatment outcomes in our setup can be primarily attributed to high abandonment, early death (ED), treatment-related mortality rates, and low recovery rates after relapse in the study setting, which commonly result from compromised supportive care and limited capacity, including unavailability of allogeneic stem cell transplantation [26]. In addition, the variation in survival probabilities across the study settings might have resulted from differences in cytogenetic profiles and pathohistological characteristics of the malignancies [32,33,36,37].…”