Immunophenotypic and genotypic features, clinical characteristics, and treatment outcome of adult pro-B acute lymphoblastic leukemia

• Verfasst von: Ludwig, Wolf-Dieter [VerfasserIn]
• Verfasst von: Rieder, Harald [VerfasserIn]
• Verfasst von: Bartram, Claus R. [VerfasserIn]
• Verfasst von: Heinze, Barbara [VerfasserIn]
• Verfasst von: Schwartz, Stefan [VerfasserIn]
• Verfasst von: Gassmann, Winfried [VerfasserIn]
• Verfasst von: Löffler, Helmut [VerfasserIn]
• Verfasst von: Hossfeld, Dieter K. [VerfasserIn]
• Verfasst von: Heil, Gerhard [VerfasserIn]
• Verfasst von: Handt, Susanne [VerfasserIn]
• Verfasst von: Heyll, Axel [VerfasserIn]
• Verfasst von: Diedrich, Helmut [VerfasserIn]
• Verfasst von: Fischer, Konstanze [VerfasserIn]
• Verfasst von: Weiss, Adelheid [VerfasserIn]
• Verfasst von: Völkers, Bernd [VerfasserIn]
• Verfasst von: Aydemir, Ülker [VerfasserIn]
• Verfasst von: Fonatsch, Christa [VerfasserIn]
• Verfasst von: Gökbuget, Nicola [VerfasserIn]
• Verfasst von: Thiel, Eckhard [VerfasserIn]
• Verfasst von: Hoelzer, Dieter [VerfasserIn]
• Titel: Immunophenotypic and genotypic features, clinical characteristics, and treatment outcome of adult pro-B acute lymphoblastic leukemia
• Titelzusatz: results of the German Multicenter Trials GMALL 03/87 and 04/89
• Verf.angabe: Wolf-Dieter Ludwig, Harald Rieder, Claus R. Bartram, Barbara Heinze, Stefan Schwartz, Winfried Gassmann, Helmut Löffler, Dieter Hossfeld, Gerhard Heil, Susanne Handt, Axel Heyll, Helmut Diedrich, Konstanze Fischer, Adelheid Weiss, Bernd Völkers, Ülker Aydemir, Christa Fonatsch, Nicola Gökbuget, Eckhard Thiel, Dieter Hoelzer
• Jahr: 1998
• Umfang: 12 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 14. Dezember 2020 ; Gesehen am 08.01.2024
• Titel Quelle: Enthalten in: Blood
• Ort Quelle: Washington, DC : American Society of Hematology, 1946
• Jahr Quelle: 1998
• Band/Heft Quelle: 92(1998), 6, Seite 1898-1909
• ISSN Quelle: 1528-0020
• DOI: doi:10.1182/blood.V92.6.1898
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1877432555

Abstract

In contrast to childhood acute lymphoblastic leukemia (ALL), the cell-biological features, clinical characteristics, and treatment outcome of CD10− pro-B ALL have not yet been determined in larger series of adult patients. Therefore, we studied 57 adult patients with newly diagnosed pro-B ALL (median age, 30 years) enrolled in two consecutive German multicenter ALL studies (03/87 and 04/89). Extensive immunophenotypic characterization of leukemic blasts could be performed on all patients, whereas adequate cytogenetic data were available in 33 cases and molecular studies in 18 cases, using reverse transcription-polymerase chain reaction to detect MLL-AF-4 transcripts. Twenty-two patients demonstrated a t(4;11)(q21;q23) and/or MLL-AF-4 rearrangements, and 6 patients had other structural abnormalities, including a t(9;22)(q34;q11) (N = 2). Nine patients had a normal karyotype. Patients with 11q23 abnormalities tended to be younger (median age, 29 years) and were characterized by male predominance (64%), hyperleukocytosis (median leukocyte count, 168 × 109/L), and a frequent coexpression of CD65s (64%) as compared with patients with other cytogenetic abnormalities or a normal karyotype. Twelve of 16 (75%) pro-B ALL patients in study 03/87 and 30 of 41 (73%) in study 04/89 achieved a complete remission (CR). Sixteen of 30 patients in study 04/89 remain in continuous CR (CCR) in contrast to only 2 of 12 patients in study 03/87. Interestingly, all 7 patients treated with high-dose cytarabine and mitoxantrone as consolidation in study 04/89 remain alive and leukemia-free. One patient in study 03/87 and 8 in study 04/89 underwent autologous (N = 2) or allogeneic (N = 7) bone marrow transplantation (BMT). The median remission duration was 420 days for patients in study 03/87 and has not yet been reached in study 04/89. The median survival time of all pro-B ALL patients was 571 days in study 03/87 and 747 days in study 04/89. Among the 22 patients with a t(4;11) and/or MLL-AF-4 rearrangements, 17 achieved a CR and 8 are still in CCR, of whom 4 underwent an allogeneic BMT. Remission duration and overall survival did not differ significantly between pro-B ALL patients with 11q23 abnormalities and those with a normal karyotype or other structural abnormalities. These data indicate that intensification of postremission treatment may improve the prognosis of adult pro-B ALL, including patients with a t(4;11). © 1998 by The American Society of Hematology.