Newly diagnosed acute lymphoblastic leukemia in China (II): prognosis related to genetic abnormalities in a series of 1091 cases

• Published in: Leukemia Vol. 26; no. 7; pp. 1507 - 1516
• Main Authors: Mi, J-Q, Wang, X, Yao, Y, Lu, H-J, Jiang, X-X, Zhou, J-F, Wang, J-H, Jiao, B, Shen, S-H, Tang, J-Y, Gu, L-J, Jiang, H, Ma, L-Y, Hao, S-G, Chen, F-Y, Xiong, S-M, Shen, Z-X, Chen, Z, Chen, B, Chen, S-J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.07.2012; Nature Publishing Group
• Subjects: 631/67/68; 692/699/67/1990/283/2125; 692/700/1750; 692/700/478/174; Abnormalities; Acute lymphoblastic leukemia; Acute lymphocytic leukemia; Adolescent; Adult; Aged; Biological and medical sciences; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Cancer Research; Care and treatment; Child; Child, Preschool; Children; China; Chromosome Aberrations; Chromosome Disorders; Critical Care Medicine; Cytogenetics; Development and progression; Female; Gene expression; Genetic abnormalities; Genetic variation; Genomics; Hematologic and hematopoietic diseases; Hematology; Hospitals; Humans; Identification and classification; Immunophenotyping; Infant; Infant, Newborn; Intensive; Internal Medicine; Karyotyping; Kinases; Leukemia; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukemogenesis; Lymphatic leukemia; Lymphocytes T; Male; Markers; Medical prognosis; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Oncology; original-article; Patients; Pediatrics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - metabolism; Prognosis; Protein-tyrosine kinase; Survival Rate; Tyrosine; Young Adult; Asia; China; acute lymphoblastic leukemia; prognosis; Prognosis; Hematology; Lymphoproliferative syndrome; Genetics; Early stage; Malignant hemopathy; Acute lymphocytic leukemia; IKZF1; Cancer; CRLF2
• ISSN: 0887-6924; 1476-5551
• DOI: 10.1038/leu.2012.23

The molecular characterization of cytogenetic abnormalities has not only provided insights into the mechanisms of leukemogenesis but also led to the establishment of new treatment strategies targeting these abnormalities and thereby further improve the prognosis of patients. We analyzed the prognosis of 1091 Chinese patients with newly diagnosed acute lymphoblastic leukemia (ALL) and explored the prognostic impacts of a large number of cytogenetic/molecular abnormalities. It was demonstrated that, in both B- and T-ALL settings, the prognosis was negatively correlated to the age as reported to date. For childhood T-ALL patients, it was also documented that the HOX11 expression represented a favorable prognostic factor as it was in adult ones. We identified CRLF2 overexpression as an intermediate-risk marker and Ik6 variant of IKZF1 gene as a high-risk one when stratifying pediatric B-ALL cases according to cytogenetic/molecular risks. We also found that Ik6 variant and CRLF2 overexpression had an important role in dictating the prognosis of Ph-negative patients, which may be useful markers in guiding the treatment of ALL in the future, with tyrosine kinase inhibitors on the other hand reversing the fate of Ph-positive ALL patients.