Authors: A WrzesieńKuś T Robak A Pluta M Zwolińska E Wawrzyniak A Wierzbowska A Skotnicki B Jakubas J Hołowiecki K Nowak K Kuliczkowski G Mazur O Haus A Dmoszyńska M AdamczykCioch W W Jędrzejczak M Paluszewska L Konopka G Pałynyczko
Publish Date: 2006/03/08
Volume: 85, Issue: 6, Pages: 366-373
Abstract
Patients with Philadelphia chromosomepositive Ph+ and/or BCR–ABL+ acute lymphoblastic leukemia ALL have extremely poor prognoses Most of these patients have additional heterogenous karyotype abnormalities the majority of which have uncertain clinical significance In this study we analyzed the clinical characteristics karyotype abnormalities and outcome of 77 patients with Ph+ and/or BCR–ABL+ ALL registered in Poland in 1997–2004 In 31/55 patients with known karyotype the sole t922q34q11 abnormality had been diagnosed in one patient variant translocation t4922q21q311q34q11 and additional abnormalities in 23 42 patients had been diagnosed The characteristics of the patients with Ph chromosome and additional abnormalities were not significantly different when compared with the entire analyzed group Out of 77 patients 54 70 achieved first complete remission CR1 after one or more induction cycles The overall survival OS probability of 2 years was 63 43 and 17 for patients treated with allogeneic stem cell transplantation alloSCT autologous SCT and chemotherapy respectively log rank p=0002 Median OS from the time of alloSCT was significantly longer for patients transplanted in CR1 compared with alloSCT in CR 1 p=0032 There were no significant differences in CR rate diseasefree survival DFS and OS for patients with t922 and additional abnormalities compared with the whole group Only WBC 20 G/l at diagnosis adversely influenced OS probability log rank p=00017 In conclusion our data confirm poor outcome of Ph+ and/or BCR–ABL+ ALL Only patients who received alloSCT in CR1 had longer DFS and OS We have shown that additional karyotype abnormalities did not influence the clinical characteristics of the patients however their influence on treatment results needs to be further assessedThe following members of the PALG were also authors of this publication and recruited five or less patients to the analysis or verified five or less karyotypes with additional abnormalities Salamaczuk Z Department of Hematology Collegium Medicum of Jagiellonian University Kraków Poland Mariaska B Nasilkowska Z Warzocha K Institute of Hematology and Transfusiology Warsaw Poland Kloczko J Mazgajska K Piszcz J Department of Hematology Medical University Bialystok Poland Panasiuk B Department of Clinical Genetics Medical University Bialystok KrawczykKuliś M and Giebel S Department of Hematology and Bone Marrow Transplantation Silesian Medical University Katowice Poland
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