A report from the LALA-94 and LALA-SA groups on hypodiploidy with 30 to 39 chromosomes and near-triploidy: 2 possible expressions of a sole entity conferring poor prognosis in adult acute lymphoblastic leukemia (ALL).
To reveal the relationship between hypodiploidy with 30 to 39 chromosomes and near-triploidy in acute lymphoblastic leukemia (ALL), we studied 24 patients presenting with one of these aneuploidies among 623 adults with ALL registered in the Leucemie Aigue Lymphoblastique de l'Adulte (LALA) protocols. The 2 ploidy groups presented a striking similarity of their cytogenetic profiles: chromosomes 2, 3, 4, 7, 13, 15, 16, and 17, significantly monosomic in hypodiploidy 30 to 39, were also frequently disomic in near-triploidy, whereas those retained in pairs in hypodiploidy 30 to 39 were frequently tetrasomic in near-triploidy. DNA content data revealed the simultaneous presence of 2 aneuploid peaks in most tested cases (DNA indexes: 0.72-0.87/1.39-1.89) and a multiple correspondence analysis applied on cytogenetic profiles ascertained their strong relationship. We thus assumed that near-triploidy derives from the duplication of hypodiploidy with 30 to 39 chromosomes and that both aneuploid groups are 2 expressions of the same disease. These 24 patients presented with B-cell phenotype, low leukocytoses (median white blood cell count, 4.2 x 10(9)/L), and poor prognosis (complete remission, 57%; median disease-free-survival, 8 months; median survival, 10.4 months) comparable to that of Ph(+) patients treated according to the same protocol. We suggest that hypodiploidy with 30 to 39 chromosomes or near-triploidy should be regarded as a new high-risk factor in the risk stratification of adult ALL protocols.
Charrin
Christiane
C
Laboratoire d'Hématologie et de Cytogénétique, Hôpital Edouard Herriot, Place d'Arsonval, 69437 Lyon Cedex 03, France. christiane.charrin@chu-lyon.fr
Thomas
Xavier
X
Ffrench
Martine
M
Le
Quoc-Hung
QH
Andrieux
Joris
J
Mozziconacci
Marie-Joelle
MJ
Laï
Jean-Luc
JL
Bilhou-Nabera
Chrystele
C
Michaux
Lucienne
L
Bernheim
Alain
A
Bastard
Christian
C
Mossafa
Hossein
H
Perot
Christine
C
Maarek
Odile
O
Boucheix
Claude
C
Lheritier
Véronique
V
Delannoy
André
A
Fière
Denis
D
Dastugue
Nicole
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D002877:Chromosomes, Human / Q000235:genetics*; D004171:Diploidy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D011123:Polyploidy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000175:diagnosis* / Q000235:genetics* / Q000276:immunology; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome