title: Variant Philadelphia translocations: molecular-cytogenetic characterization and prognostic influence on frontline imatinib therapy, a GIMEMA Working Party on CML analysis.
abstract: Variant Philadelphia (Ph) chromosome translocations have been reported in 5%-10% of patients with newly diagnosed chronic myeloid leukemia (CML). Variant translocations may involve one or more chromosomes in addition to 9 and 22, and can be generated by 2 different mechanisms, 1-step and 2-step rearrangements, as revealed by fluorescence in situ hybridization. The prognostic significance of the occurrence of variant translocations has been discussed in previous studies. The European LeukemiaNet recommendations do not provide a "warning" for patients with variant translocations, but there is limited information about their outcome after therapy with tyrosine kinase inhibitors. To identify the role of variant translocations in early chronic phase (CP) CML patients treated with imatinib mesylate, we performed an analysis in a large series of 559 patients enrolled in 3 prospective imatinib trials of the Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA) Working Party on CML. Variant translocations occurred in 30 patients (5%). Our data show that the presence of variant translocations has no impact on the cytogenetic and molecular response or on outcome, regardless of the involvement of different mechanisms, the number of involved chromosomes, or the presence of deletions. Therefore, we suggest that patients with variant translocations do not constitute a "warning" category in the imatinib era. This study is registered at www.clinicaltrials.gov as NCT00514488 and NCT00510926.
authors: Department of Hematology and Oncology L. e A. Seràgnoli, University of Bologna, Bologna, Italy.
authors: Giulia
authors: G
authors: Marzocchi
authors: Fausto
authors: F
authors: Castagnetti
authors: Simona
authors: S
authors: Luatti
authors: Carmen
authors: C
authors: Baldazzi
authors: Monica
authors: M
authors: Stacchini
authors: Gabriele
authors: G
authors: Gugliotta
authors: Marilina
authors: M
authors: Amabile
authors: Giorgina
authors: G
authors: Specchia
authors: Mario
authors: M
authors: Sessarego
authors: Ursula
authors: U
authors: Giussani
authors: Laura
authors: L
authors: Valori
authors: Giancarlo
authors: G
authors: Discepoli
authors: Anna
authors: A
authors: Montaldi
authors: Alessandra
authors: A
authors: Santoro
authors: Laura
authors: L
authors: Bonaldi
authors: Giovanni
authors: G
authors: Giudici
authors: Anna Maria
authors: AM
authors: Cianciulli
authors: Francesca
authors: F
authors: Giacobbi
authors: Francesca
authors: F
authors: Palandri
authors: Fabrizio
authors: F
authors: Pane
authors: Giuseppe
authors: G
authors: Saglio
authors: Giovanni
authors: G
authors: Martinelli
authors: Michele
authors: M
authors: Baccarani
authors: Gianantonio
authors: G
authors: Rosti
authors: Nicoletta
authors: N
authors: Testoni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001549:Benzamides; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; 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*; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate