Prognostic impact of bone marrow karyotype in childhood acute lymphoblastic leukaemia: Swedish experiences 1986-91.
The prognostic value of cytogenetic classification in acute lymphoblastic leukaemia (ALL) was evaluated in Swedish children below 16 years of age (n = 372) diagnosed between 1986 and 1991. A bone marrow karyotype was obtained in 281 cases, of which 149 (53%) showed clonal abnormalities. Event-free survival (p-EFS) was 0.64-0.69 in patients with diploid and pseudodiploid karyotype. Patients with massive hyperdiploidy (> 50 chromosomes) had the best outcome (p-EFS = 0.76) and those with hypodiploidy (< 46 chromosomes) had the worst (p-EFS = 0.33). White blood cell count and age were the strongest predictors of outcome. The karyotype reached borderline significance. The diagnostic karyotype was also a predictor of outcome after relapse, with hyperdiploid patients doing better than the others. The presence of a structural chromosomal abnormality did not constitute a negative prognostic factor when intensive chemotherapy was given.
Forestier
E
E
Department of Paediatrics, University of Umeå, Sweden.
Gustafsson
G
G
von Heideman
A
A
Heim
S
S
Hernell
O
O
Mitelman
F
F
Nordenson
I
I
Swolin
B
B
Söderhäll
S
S
D000293:Adolescent; D001854:Bone Marrow Cells; D002648:Child; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D016036:Seroepidemiologic Studies; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014178:Translocation, Genetic