Additional chromosomal abnormalities and their prognostic significance in adult Philadelphia-positive acute lymphoblastic leukemia: with or without imatinib in chemotherapy

Ann Hematol. 2009 Nov;88(11):1069-77. doi: 10.1007/s00277-009-0720-z. Epub 2009 Mar 10.

Abstract

The study analyzed the characteristics and prognostic significance of additional chromosomal abnormalities in 110 Chinese adults with Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL). Secondary aberrations were present in 60.9% of the cases. All chromosomes were involved in secondary aberrations, and chromosomes 9, 7, 21, 18, and 14 were most frequently abnormal. Fifty of 110 patients (45.5%) had at least one normal metaphase cell in their chromosome preparations at diagnosis. Patients with additional aberrations had shorter disease-free survival (DFS) and overall survival (OS) in chemotherapy combined with imatinib (ICT) group and only shorter DFS in conventional chemotherapy (CT) group. The existence of normal metaphase cells was associated with a superior survival in CT group, but not in ICT group. Patients with loss of chromosomes 7, 7p, 9, and 9p had inferior outcome compared to patients with other secondary aberrations and those without secondary aberrations, in both CT and ICT group.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Asparaginase / administration & dosage
  • Benzamides
  • Chromosome Aberrations*
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Daunorubicin / administration & dosage
  • Disease-Free Survival
  • Etoposide / administration & dosage
  • Female
  • Fusion Proteins, bcr-abl / antagonists & inhibitors
  • Humans
  • Imatinib Mesylate
  • Kaplan-Meier Estimate
  • Male
  • Mercaptopurine / administration & dosage
  • Methotrexate / administration & dosage
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • Piperazines / administration & dosage
  • Piperazines / therapeutic use*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Prednisone / administration & dosage
  • Prognosis
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use*
  • Salvage Therapy*
  • Vincristine / administration & dosage
  • Vindesine / administration & dosage
  • Young Adult

Substances

  • Benzamides
  • Piperazines
  • Pyrimidines
  • Cytarabine
  • Vincristine
  • Etoposide
  • Imatinib Mesylate
  • Cyclophosphamide
  • Mitoxantrone
  • Mercaptopurine
  • Fusion Proteins, bcr-abl
  • Asparaginase
  • Vindesine
  • Prednisone
  • Methotrexate
  • Daunorubicin