Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial.

  title={Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial.},
  author={Anthony V. Moorman and Christine J. Harrison and Georgina Buck and S. M. Richards and Lorna M. Secker-Walker and Mary Martineau and Gail H Vance and Athena M Cherry and Rodney R. Higgins and Adele K. Fielding and Letizia Foroni and Elisabeth Paietta and Martin S. Tallman and Mark R. Litzow and Peter H Wiernik and Jacob M. Rowe and Anthony H. Goldstone and Gordon W. Dewald},
  volume={109 8},
Pretreatment cytogenetics is a known predictor of outcome in hematologic malignancies. However, its usefulness in adult acute lymphoblastic leukemia (ALL) is generally limited to the presence of the Philadelphia (Ph) chromosome because of the low incidence of other recurrent abnormalities. We present centrally reviewed cytogenetic data from 1522 adult patients enrolled on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. The incidence and clinical… 

Figures and Tables from this paper

Prognostic value of cytogenetics in adult patients with Philadelphia-negative acute lymphoblastic leukemia

Karyotype is a useful tool for risk assessment in adult ALL and the bad prognosis of t(4;11)(q21;q23)/MLL/AF4 and hypodiploidy is confirmed, which could also define a high-risk group of patients who might be candidates for more intensive treatment.

The Prognostic Impact of the Karyotype in Patients with Acute Lymphoblastic Leukemia

A new classification of chromosome abnormalities in cytogenetic risk groups was proposed that took into account the proposed cytogenetics risk groups from MRC UKALLXII / ECOG 2993 study and found that patients with a Ph1 chromosome or Philadelphia chromosome have a very severe prognosis.

Impact of cytogenetics on the outcome of adult acute lymphoblastic leukemia: results of Southwest Oncology Group 9400 study.

After accounting for the variation among karyotype groups, age was not a significant prognostic factor for OS or RFS, highlighting cytogenetics as the most important prognostic factors in adult ALL.

Impact of cytogenetic abnormalities in adults with Ph-negative B-cell precursor acute lymphoblastic leukemia.

Only 2 subgroups, namely t(4;11)/KMT2A-AFF1 and 14q32/IGH translocations, displayed a significantly worse outcome in this context, still observed after adjustment for age and after censoring patients who received allogeneic stem cell transplantation (SCT) in first remission at SCT time.

T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993).

This study provides a baseline for trials of new drugs, such as nelarabine, and may allow risk-adapted therapy in patients with poor-prognosis T-cell ALL.

Prognostic impact of cytogenetic abnormalities in adult patients with Philadelphia chromosome-negative ALL who underwent an allogeneic transplant

Treatment outcomes of Ph-negative ALL patients with HR cytogenetic abnormalities may improve following allo-SCT, especially in the first remission, and innovative transplant approaches are warranted in patients who are not in remission.

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

The observations show that molecular-cytogenetic aberrations are an independent prognostic factor in adult ALL - they allow predicting therapy resistance and the OS time after intense treatment, and emphasize the lack of influence of cytogeneticAberrations on the CR and the time to achieve CR.

Monosomal karyotype is associated with poor outcomes in patients with Philadelphia chromosome–negative acute lymphoblastic leukemia receiving chemotherapy but not allogeneic hematopoietic stem cell transplantation

It was shown that MK was an independent predictor of poor outcomes in patients with Ph-negative ALL receiving chemotherapy but not allo-HSCT, and allo -HSCT could improve the outcomes of patients with MK.



Interphase molecular cytogenetic screening for chromosomal abnormalities of prognostic significance in childhood acute lymphoblastic leukaemia: a UK Cancer Cytogenetics Group Study

The use of centromeric probes revealed significant hidden high hyperdiploidy of 33% and 59%, respectively, in patients with normal or failed cytogenetic results, highlighting the importance of iFISH as a complementary tool to cytogenetics in routine screening for significant chromosomal abnormalities in ALL.

The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties.

Subgroup analysis demonstrated that the three cytogenetically defined prognostic groups retained their predictive value in the context of secondary as well as de novo AML, within the pediatric age group and furthermore were found to be a key determinant of outcome from autologous or allogeneic bone marrow transplantation (BMT) in first CR.

Prospective karyotype analysis in adult acute lymphoblastic leukemia: the cancer and leukemia Group B experience.

It is concluded that cytogenetic analysis at diagnosis should be used to guide treatment decisions in adults with acute lymphoblastic leukemia and remained the most important factor for DFS.

Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993.

Adult Ph-negative ALL patients, however, can attain long-term disease-free survival using SCT as well as conventional chemotherapy.

Cytogenetic abnormalities in adult acute lymphoblastic leukemia: correlations with hematologic findings outcome. A Collaborative Study of the Group Français de Cytogénétique Hématologique.

  • Medicine
  • 1996
It was showed that the same recurrent abnormalities as those reported in childhood ALL are found in adults, and it determined their frequencies and distribution according to age, and the ploidy groups with a favorable prognostic impact were hyperdiploidy greater than 50 without Ph chromosome and tetraploidsy.

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

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.

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

Cytogenetic classification of 350 adults with acute lymphoblastic leukaemia on MRC UKALL XA trial showed the following statistically significant associations: t(9;22) (11%) increased with increasing

Partial deletions of long arm of chromosome 6: biologic and clinical implications in adult acute lymphoblastic leukemia

This anomaly, as an isolated change, identifies a subset of cases with hyperleukocytosis and a strict correlation with a T cell phenotype and seems to be associated with an unfavorable clinical outcome, although this finding will need to be confirmed by extended FISH analysis.

Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993.

The data demonstrate that achieving CR with induction therapy is indispensable for long-term survival in adult patients with ALL, and the induction regimen was highly efficacious as remission-inducing therapy.

A comprehensive genetic classification of adult acute lymphoblastic leukemia (ALL): analysis of the GIMEMA 0496 protocol.

The importance of a combined cytogenetic-molecular profiling of adult ALL at presentation as a critical independent determinant of their outcome is highlighted, providing further evidence of the necessity of a risk-adapted therapeutic algorithm for an optimal management of these patients.