Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia
Abstract Context: In acute lymphoblastic leukemia (ALL), the most important prognostic factors are age, leukocyte count at presentation, immunophenotype, and cytogenetic abnormalities. The cytogenetic abnormalities are associated with distinct immunologic phenotypes of ALL and characteristic outcome...
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| Veröffentlicht in: | South Asian Journal of Cancer 2018-10, Vol.7 (4), p.263-266 |
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| container_title | South Asian Journal of Cancer |
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| creator | Chennamaneni, Rachana Gundeti, Sadashivudu Konatam, Meher Lakshmi Bala, Stalin Kumar, Ashok Srinivas, Lakshmi |
| description | Abstract
Context:
In acute lymphoblastic leukemia (ALL), the most important prognostic factors are age, leukocyte count at presentation, immunophenotype, and cytogenetic abnormalities. The cytogenetic abnormalities are associated with distinct immunologic phenotypes of ALL and characteristic outcomes.
Aims:
The present study was primarily aimed at analyzing the impact of cytogenetics on postinduction responses and event-free survival (EFS) in pediatric patients with ALL. The secondary objective was to study the overall survival (OS).
Subjects and Methods:
A total of 240 patients with age |
| doi_str_mv | 10.4103/sajc.sajc_13_18 |
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Context:
In acute lymphoblastic leukemia (ALL), the most important prognostic factors are age, leukocyte count at presentation, immunophenotype, and cytogenetic abnormalities. The cytogenetic abnormalities are associated with distinct immunologic phenotypes of ALL and characteristic outcomes.
Aims:
The present study was primarily aimed at analyzing the impact of cytogenetics on postinduction responses and event-free survival (EFS) in pediatric patients with ALL. The secondary objective was to study the overall survival (OS).
Subjects and Methods:
A total of 240 patients with age <18 years and diagnosed with ALL between January 2011 and June 2016 were retrospectively analyzed. Cytogenetics was evaluated with conventional karyotyping or reverse transcriptase polymerase chain reaction. Based on cytogenetic abnormalities, the patients were grouped into five categories, and the outcomes were analyzed.
Results:
Of the 240 patients, 125 (52%) patients had evaluable cytogenetics. Of these, 77 (61.6%) patients had normal cytogenetics, 19 (15.2%) had t(9;22) translocation, 10 (8%) had unfavorable cytogenetics which included t(9;11), hypodiploidy, and complex karyotype, 10 (8%) had favorable cytogenetics which included t(12;21), t(1;19), and high hyperdiploidy, 9 (7.2%) had miscellaneous cytogenetics. Seventy-one percent of patients were treated with MCP 841 protocol, while 29% of patients received BFM-ALL 95 protocol. The 3-year EFS and OS of the entire group were 52% and 58%, respectively. On univariate analysis, EFS and OS were significantly lower in t(9;22) compared to normal cytogenetics (P = 0.033 and P = 0.0253, respectively) and were not significant for other subgroups compared to normal cytogenetics. On multivariate analysis, EFS was significantly lower for t(9;22) and unfavorable subgroups.
Conclusions:
Cytogenetics plays an important role in the molecular characterization of ALL defining the prognostic subgroups. Patients with unfavorable cytogenetics and with t(9;22) have poorer outcomes.</description><identifier>ISSN: 2278-330X</identifier><identifier>EISSN: 2278-4306</identifier><identifier>DOI: 10.4103/sajc.sajc_13_18</identifier><identifier>PMID: 30430098</identifier><language>eng</language><publisher>A-12, 2nd Floor, Sector 2, Noida-201301 UP, India: Thieme Medical and Scientific Publishers Pvt. Ltd</publisher><subject>Acute lymphoblastic leukemia ; cytogenetics ; event-free survival ; ORIGINAL ARTICLE: Hematolymphoid Malignancies ; overall survival ; pediatric</subject><ispartof>South Asian Journal of Cancer, 2018-10, Vol.7 (4), p.263-266</ispartof><rights>MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)</rights><rights>Copyright: © 2018 The South Asian Journal of Cancer 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c633e-adf4af2b6ba5164fbeff1c0f3b230e210bfdfb0995190f8e45855569cec35ff23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190389/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190389/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,20891,27924,27925,53791,53793,54587</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30430098$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chennamaneni, Rachana</creatorcontrib><creatorcontrib>Gundeti, Sadashivudu</creatorcontrib><creatorcontrib>Konatam, Meher Lakshmi</creatorcontrib><creatorcontrib>Bala, Stalin</creatorcontrib><creatorcontrib>Kumar, Ashok</creatorcontrib><creatorcontrib>Srinivas, Lakshmi</creatorcontrib><title>Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia</title><title>South Asian Journal of Cancer</title><addtitle>South Asian J Cancer</addtitle><description>Abstract
Context:
In acute lymphoblastic leukemia (ALL), the most important prognostic factors are age, leukocyte count at presentation, immunophenotype, and cytogenetic abnormalities. The cytogenetic abnormalities are associated with distinct immunologic phenotypes of ALL and characteristic outcomes.
Aims:
The present study was primarily aimed at analyzing the impact of cytogenetics on postinduction responses and event-free survival (EFS) in pediatric patients with ALL. The secondary objective was to study the overall survival (OS).
Subjects and Methods:
A total of 240 patients with age <18 years and diagnosed with ALL between January 2011 and June 2016 were retrospectively analyzed. Cytogenetics was evaluated with conventional karyotyping or reverse transcriptase polymerase chain reaction. Based on cytogenetic abnormalities, the patients were grouped into five categories, and the outcomes were analyzed.
Results:
Of the 240 patients, 125 (52%) patients had evaluable cytogenetics. Of these, 77 (61.6%) patients had normal cytogenetics, 19 (15.2%) had t(9;22) translocation, 10 (8%) had unfavorable cytogenetics which included t(9;11), hypodiploidy, and complex karyotype, 10 (8%) had favorable cytogenetics which included t(12;21), t(1;19), and high hyperdiploidy, 9 (7.2%) had miscellaneous cytogenetics. Seventy-one percent of patients were treated with MCP 841 protocol, while 29% of patients received BFM-ALL 95 protocol. The 3-year EFS and OS of the entire group were 52% and 58%, respectively. On univariate analysis, EFS and OS were significantly lower in t(9;22) compared to normal cytogenetics (P = 0.033 and P = 0.0253, respectively) and were not significant for other subgroups compared to normal cytogenetics. On multivariate analysis, EFS was significantly lower for t(9;22) and unfavorable subgroups.
Conclusions:
Cytogenetics plays an important role in the molecular characterization of ALL defining the prognostic subgroups. Patients with unfavorable cytogenetics and with t(9;22) have poorer outcomes.</description><subject>Acute lymphoblastic leukemia</subject><subject>cytogenetics</subject><subject>event-free survival</subject><subject>ORIGINAL ARTICLE: Hematolymphoid Malignancies</subject><subject>overall survival</subject><subject>pediatric</subject><issn>2278-330X</issn><issn>2278-4306</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>DOA</sourceid><recordid>eNp1kUFrGzEQhUVoSYKbc25Ff8DOaLWraC-FYtrEYOglgdyEpB3ZcndXi7Rb8L-vHCdufchFEqM33xvmEXLLYFEy4HdJ7-zicCjGFZMX5Loo7uW85CA-vb05h5crcpPSDgByD5c1uyRXHLIIanlN1qtu0HakwVG7H8MGexy9TTT0NEyjDR0m6ns6YOP1GL2l2k4j0nbfDdtgWp2ymrY4_cbO6y_ks9Ntwpu3e0aef_54Wj7O178eVsvv67kVnONcN67UrjDC6IqJ0hl0jllw3BQcsGBgXOMM1HXFanASy0pWVSVqi5ZXzhV8RlZHbhP0Tg3RdzruVdBevRZC3Cgd82AtKhDyYMSMFVBmE4mWcVHWRujKSAeZ9e3IGibTYWOxH6Nuz6DnP73fqk34o0QeLq8zA-6OABtDShHdqZeBOuSkXiP6l1Pu-Pq_5Un_nkoWLI6CceuxQ7ULU-zzQj8k_gWFPqML</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Chennamaneni, Rachana</creator><creator>Gundeti, Sadashivudu</creator><creator>Konatam, Meher Lakshmi</creator><creator>Bala, Stalin</creator><creator>Kumar, Ashok</creator><creator>Srinivas, Lakshmi</creator><general>Thieme Medical and Scientific Publishers Pvt. Ltd</general><general>Medknow Publications & Media Pvt Ltd</general><scope>0U6</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20181001</creationdate><title>Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia</title><author>Chennamaneni, Rachana ; Gundeti, Sadashivudu ; Konatam, Meher Lakshmi ; Bala, Stalin ; Kumar, Ashok ; Srinivas, Lakshmi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c633e-adf4af2b6ba5164fbeff1c0f3b230e210bfdfb0995190f8e45855569cec35ff23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute lymphoblastic leukemia</topic><topic>cytogenetics</topic><topic>event-free survival</topic><topic>ORIGINAL ARTICLE: Hematolymphoid Malignancies</topic><topic>overall survival</topic><topic>pediatric</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chennamaneni, Rachana</creatorcontrib><creatorcontrib>Gundeti, Sadashivudu</creatorcontrib><creatorcontrib>Konatam, Meher Lakshmi</creatorcontrib><creatorcontrib>Bala, Stalin</creatorcontrib><creatorcontrib>Kumar, Ashok</creatorcontrib><creatorcontrib>Srinivas, Lakshmi</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>South Asian Journal of Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chennamaneni, Rachana</au><au>Gundeti, Sadashivudu</au><au>Konatam, Meher Lakshmi</au><au>Bala, Stalin</au><au>Kumar, Ashok</au><au>Srinivas, Lakshmi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia</atitle><jtitle>South Asian Journal of Cancer</jtitle><addtitle>South Asian J Cancer</addtitle><date>2018-10-01</date><risdate>2018</risdate><volume>7</volume><issue>4</issue><spage>263</spage><epage>266</epage><pages>263-266</pages><issn>2278-330X</issn><eissn>2278-4306</eissn><abstract>Abstract
Context:
In acute lymphoblastic leukemia (ALL), the most important prognostic factors are age, leukocyte count at presentation, immunophenotype, and cytogenetic abnormalities. The cytogenetic abnormalities are associated with distinct immunologic phenotypes of ALL and characteristic outcomes.
Aims:
The present study was primarily aimed at analyzing the impact of cytogenetics on postinduction responses and event-free survival (EFS) in pediatric patients with ALL. The secondary objective was to study the overall survival (OS).
Subjects and Methods:
A total of 240 patients with age <18 years and diagnosed with ALL between January 2011 and June 2016 were retrospectively analyzed. Cytogenetics was evaluated with conventional karyotyping or reverse transcriptase polymerase chain reaction. Based on cytogenetic abnormalities, the patients were grouped into five categories, and the outcomes were analyzed.
Results:
Of the 240 patients, 125 (52%) patients had evaluable cytogenetics. Of these, 77 (61.6%) patients had normal cytogenetics, 19 (15.2%) had t(9;22) translocation, 10 (8%) had unfavorable cytogenetics which included t(9;11), hypodiploidy, and complex karyotype, 10 (8%) had favorable cytogenetics which included t(12;21), t(1;19), and high hyperdiploidy, 9 (7.2%) had miscellaneous cytogenetics. Seventy-one percent of patients were treated with MCP 841 protocol, while 29% of patients received BFM-ALL 95 protocol. The 3-year EFS and OS of the entire group were 52% and 58%, respectively. On univariate analysis, EFS and OS were significantly lower in t(9;22) compared to normal cytogenetics (P = 0.033 and P = 0.0253, respectively) and were not significant for other subgroups compared to normal cytogenetics. On multivariate analysis, EFS was significantly lower for t(9;22) and unfavorable subgroups.
Conclusions:
Cytogenetics plays an important role in the molecular characterization of ALL defining the prognostic subgroups. Patients with unfavorable cytogenetics and with t(9;22) have poorer outcomes.</abstract><cop>A-12, 2nd Floor, Sector 2, Noida-201301 UP, India</cop><pub>Thieme Medical and Scientific Publishers Pvt. Ltd</pub><pmid>30430098</pmid><doi>10.4103/sajc.sajc_13_18</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; PubMed Central Open Access; Thieme Connect Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Acute lymphoblastic leukemia cytogenetics event-free survival ORIGINAL ARTICLE: Hematolymphoid Malignancies overall survival pediatric |
| title | Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia |
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