Faculty Collaboration Database

Clinical heterogeneity in childhood acute lymphoblastic leukemia with 11q23 rearrangements. Leukemia 2003 Apr;17(4):700-6

Date

04/12/2003

Pubmed ID

12682627

DOI

10.1038/sj.leu.2402883

Scopus ID

2-s2.0-0242500374 (requires institutional sign-in at Scopus site)   202 Citations

Abstract

To assess the clinical heterogeneity among patients with acute lymphoblastic leukemia (ALL) and various 11q23 abnormalities, we analyzed data on 497 infants, children and young adults treated between 1983 and 1995 by 11 cooperative groups and single institutions. The substantial sample size allowed separate analyses according to age younger or older than 12 months for the various cytogenetic subsets. Infants with t(4;11) ALL had an especially dismal prognosis when their disease was characterized by a poor early response to prednisone (P=0.0005 for overall comparison; 5-year event-free survival (EFS), 0 vs 23+/-+/-12% s.e. for those with good response), or age less than 3 months (P=0.0003, 5-year EFS, 5+/-+/-5% vs 23.4+/-+/-4% for those over 3 months). A poor prednisone response also appeared to confer a worse outcome for older children with t(4;11) ALL. Hematopoietic stem cell transplantation failed to improve outcome in either age group. Among patients with t(11;19) ALL, those with a T-lineage immunophenotype, who were all over 1 year of age, had a better outcome than patients over 1 year of age with B-lineage ALL (overall comparison, P=0.065; 5-year EFS, 88+/-+/-13 vs 46+/-14%). In the heterogeneous subgroup with del(11)(q23), National Cancer Institute-Rome risk criteria based on age and leukocyte count had prognostic significance (P=0.04 for overall comparison; 5-year EFS, 64+/-+/-8% (high risk) vs 83+/-+/-6% (standard risk)). This study illustrates the marked clinical heterogeneity among and within subgroups of infants or older children with ALL and specific 11q23 abnormalities, and identifies patients at particularly high risk of failure who may benefit from innovative therapy.

Author List

Pui CH, Chessells JM, Camitta B, Baruchel A, Biondi A, Boyett JM, Carroll A, Eden OB, Evans WE, Gadner H, Harbott J, Harms DO, Harrison CJ, Harrison PL, Heerema N, Janka-Schaub G, Kamps W, Masera G, Pullen J, Raimondi SC, Richards S, Riehm H, Sallan S, Sather H, Shuster J, Silverman LB, Valsecchi MG, Vilmer E, Zhou Y, Gaynon PS, Schrappe M

Author

Bruce m. Camitta Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Factors
Antineoplastic Combined Chemotherapy Protocols
B-Lymphocytes
Child
Child, Preschool
Chromosome Aberrations
Chromosomes, Human, Pair 11
Chromosomes, Human, Pair 19
Chromosomes, Human, Pair 4
Chromosomes, Human, Pair 9
Cohort Studies
Combined Modality Therapy
DNA-Binding Proteins
Disease-Free Survival
Drug Resistance, Neoplasm
Europe
Female
Hematopoietic Stem Cell Transplantation
Histone-Lysine N-Methyltransferase
Humans
Infant
Leukocyte Count
Male
Myeloid-Lymphoid Leukemia Protein
Neoplastic Stem Cells
Oncogene Proteins, Fusion
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prednisone
Prognosis
Proportional Hazards Models
Proto-Oncogenes
Retrospective Studies
Risk Factors
T-Lymphocytes
Transcription Factors
Translocation, Genetic
Treatment Outcome
United States