title: Prognostic value of cytogenetics in adult patients with Philadelphia-negative acute lymphoblastic leukemia.
abstract: The prognostic value of cytogenetics in adult acute lymphoblastic leukemia (ALL) is not as established as in childhood ALL. We have analyzed the outcome and prognostic value of karyotype in 84 adults diagnosed with Philadelphia-negative ALL from a single institution that received induction chemotherapy and had successful karyotype performed. The most frequent finding was normal karyotype in 35 (42%) cases, followed by aneuploidies in 20 cases (24%) and t(4;11)(q21;q23)/MLL/AF4 in 5 (6%), and the remaining 24(27%) cases carried miscellaneous clonal abnormalities. The group of patients with t(4;11)(q21;q23)/MLL/AF4, hypodiploidy and low hyperdiploidy (less than 50 chromosomes) showed a worse outcome than those with normal karyotype and miscellaneous abnormalities in terms of overall survival (OS) (3 years OS; 47% vs. 13%, p = 0.014) and relapse-free survival (RFS) (3 years RFS; 44% vs. 27%, p = 0.005). Other cytogenetic prognostic classifications reported to date were tested in our series, but any was fully reproducible. In conclusion, karyotype is a useful tool for risk assessment in adult ALL. We have confirmed the bad prognosis of t(4;11)(q21;q23)/MLL/AF4 and hypodiploidy. Besides, low hyperdiploidy could also define a high-risk group of patients who might be candidates for more intensive treatment.
authors.affiliation: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Gómez-Seguí
authors.forename: Jose
authors.initials: J
authors.lastname: Cervera
authors.forename: Esperanza
authors.initials: E
authors.lastname: Such
authors.forename: David
authors.initials: D
authors.lastname: Martínez-Cuadrón
authors.forename: Irene
authors.initials: I
authors.lastname: Luna
authors.forename: Mariam
authors.initials: M
authors.lastname: Ibáñez
authors.forename: María
authors.initials: M
authors.lastname: López-Pavía
authors.forename: Adriana
authors.initials: A
authors.lastname: Gascón
authors.forename: Mónica
authors.initials: M
authors.lastname: Roig
authors.forename: Jesús
authors.initials: J
authors.lastname: Martínez
authors.forename: Jaime
authors.initials: J
authors.lastname: Sanz
authors.forename: Pau
authors.initials: P
authors.lastname: Montesinos
authors.forename: Guillermo
authors.initials: G
authors.lastname: Martín-Aragonés
authors.forename: Ignacio
authors.initials: I
authors.lastname: Lorenzo
authors.forename: Leonor
authors.initials: L
authors.lastname: Senent
authors.forename: Eva
authors.initials: E
authors.lastname: Barragán
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cordón
authors.forename: Amparo
authors.initials: A
authors.lastname: Sempere
authors.forename: Guillermo F
authors.initials: GF
authors.lastname: Sanz
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Sanz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D003582:Cytogenetics / Q000379:methods*; D005260:Female; D006801:Humans; D059785:Karyotype; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000235:genetics*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate