Chromosome abnormalities additional to the Philadelphia chromosome at the diagnosis of chronic myelogenous leukemia: pathogenetic and prognostic implications.
Additional chromosome abnormalities (ACAs) occur in less than 10% of cases at diagnosis of Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML). In some cases, on the basis of the persistence of the ACAs in Ph-negative cells after response to imatinib, a secondary origin of the Ph chromosome has been demonstrated. In this study, the possible prognostic value of this phenomenon was evaluated. Thirty-six Ph-positive CML patients were included in the study. In six patients, ACAs persisted after the disappearance of the Ph. A complete cytogenetic response (CCR) was obtained in five of these six patients, and five of six also had a high Sokal score. In all the other cases, ACAs disappeared together (in cases of response to therapy with imatinib) or persisted with the Ph (in cases of no response to imatinib). In the former cases, the primary origin of the Ph was demonstrated. CCR was obtained in 22 cases (17 with low to intermediate Sokal scores), while no response was observed in 8 patients (5 with a high Sokal score). Sokal score seems to maintain its prognostic value for patients in whom the Ph occurs as a primary event, but not in those in whom it occurs as a secondary one.
Zaccaria
Alfonso
A
Oncology-Hematology Department, "S. Maria delle Croci" Hospital, viale Randi, 5, 48121 Ravenna, Italy. a.zaccaria@ausl.ra.it
Testoni
Nicoletta
N
Valenti
Anna Maria
AM
Luatti
Simona
S
Tonelli
Michela
M
Marzocchi
Giulia
G
Cipriani
Raffaella
R
Baldazzi
Carmen
C
Giannini
Barbara
B
Stacchini
Monica
M
Gamberini
Carla
C
Castagnetti
Fausto
F
Rosti
Gianantonio
G
Azzena
Annalisa
A
Cavazzini
Francesco
F
Cianciulli
Anna Maria
AM
Dalsass
Alessia
A
Donti
Emilio
E
Giugliano
Emilia
E
Gozzetti
Alessandro
A
Grimoldi
Maria Grazia
MG
Ronconi
Sonia
S
Santoro
Alessandra
A
Spedicato
Francesco
F
Zanatta
Lucia
L
Baccarani
Michele
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000627:therapeutic use; D012074:Remission Induction; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases