Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia

C. D. Bloomfield, A. I. Goldman, G. Alimena, R. Berger, G. H. Borgström, L. Brandt, D. Catovsky, A. de la Chapelle, G. W. Dewald, O. M. Garson, S. Garwicz, H. M. Golomb, D. K. Hossfeld, S. D. Lawler, F. Mitelman, P. Nilsson, R. V. Pierre, P. Philip, E. Prigogina, J. D. Rowley & 8 others M. Sakurai, A. A. Sandberg, L. M. Secker Walker, G. Tricot, H. Van Den Berghe, A. Van Orshoven, P. Vuopio, Jacqueline Whang-Peng

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Abstract

The importance of banded chromosome analyses in predicting long-term outcome in acute lymphoblastic leukemia (ALL) was evaluated in this follow-up study of 329 patients from the Third International Workshop on Chromosomes in Leukemia. Patients were divided into ten groups according to pretreatment karyotype: no abnormalities, one of the following structural abnormalities [the Philadelphia chromosome, translocations involving 8q24, t(4;11), 14q+, 6q-] or, in the remaining cases, model number [<46, 46, 47 to 50, > 50]. Achievement and duration of complete remission (CR) and survival differed among chromosome groups (P < .0001). Karyotype was an independent prognostic factor for duration of first CR and survival, even when age, initial leukocyte count (WBC), French-American-British (FAB) type, and immunologic phenotype were considered. Among adults, prolonged remission and survival were uncommon in all chromosome groups. Only in the normal karyotype group was median survival even two years. Among children, striking differences in long-term remission and survival were seen depending upon karyotype. Children in the > 50 group did best, with 70% remaining in first CR for a median duration in excess of five years. Children in the 47-50, 6q-, and normal karyotype groups also had prolonged survivals. In contrast, certain translocations [t(9;22)(q34;q11), t(4;11)(q21;q14-23), t(8;14)(q24;q32)] identified children who had short survivals, even in the presence of favorable prognostic factors including a low WBC, L1 morphology, and non-T, non-B immunologic phenotype. We conclude that chromosome analysis is required at diagnosis in patients with ALL, and that children with these specific translocations should be managed as having high-risk ALL.

Original languageEnglish
Pages (from-to)415-420
Number of pages6
JournalBlood
Volume67
Issue number2
Publication statusPublished - Jun 3 1986
Externally publishedYes

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Chromosomes
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Chromosome Aberrations
Karyotype
Survival
Philadelphia Chromosome
Leukemia
Phenotype
Education

ASJC Scopus subject areas

  • Hematology

Cite this

Bloomfield, C. D., Goldman, A. I., Alimena, G., Berger, R., Borgström, G. H., Brandt, L., ... Whang-Peng, J. (1986). Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia. Blood, 67(2), 415-420.

Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia. / Bloomfield, C. D.; Goldman, A. I.; Alimena, G.; Berger, R.; Borgström, G. H.; Brandt, L.; Catovsky, D.; de la Chapelle, A.; Dewald, G. W.; Garson, O. M.; Garwicz, S.; Golomb, H. M.; Hossfeld, D. K.; Lawler, S. D.; Mitelman, F.; Nilsson, P.; Pierre, R. V.; Philip, P.; Prigogina, E.; Rowley, J. D.; Sakurai, M.; Sandberg, A. A.; Secker Walker, L. M.; Tricot, G.; Van Den Berghe, H.; Van Orshoven, A.; Vuopio, P.; Whang-Peng, Jacqueline.

In: Blood, Vol. 67, No. 2, 03.06.1986, p. 415-420.

Research output: Contribution to journalArticle

Bloomfield, CD, Goldman, AI, Alimena, G, Berger, R, Borgström, GH, Brandt, L, Catovsky, D, de la Chapelle, A, Dewald, GW, Garson, OM, Garwicz, S, Golomb, HM, Hossfeld, DK, Lawler, SD, Mitelman, F, Nilsson, P, Pierre, RV, Philip, P, Prigogina, E, Rowley, JD, Sakurai, M, Sandberg, AA, Secker Walker, LM, Tricot, G, Van Den Berghe, H, Van Orshoven, A, Vuopio, P & Whang-Peng, J 1986, 'Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia', Blood, vol. 67, no. 2, pp. 415-420.
Bloomfield CD, Goldman AI, Alimena G, Berger R, Borgström GH, Brandt L et al. Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia. Blood. 1986 Jun 3;67(2):415-420.
Bloomfield, C. D. ; Goldman, A. I. ; Alimena, G. ; Berger, R. ; Borgström, G. H. ; Brandt, L. ; Catovsky, D. ; de la Chapelle, A. ; Dewald, G. W. ; Garson, O. M. ; Garwicz, S. ; Golomb, H. M. ; Hossfeld, D. K. ; Lawler, S. D. ; Mitelman, F. ; Nilsson, P. ; Pierre, R. V. ; Philip, P. ; Prigogina, E. ; Rowley, J. D. ; Sakurai, M. ; Sandberg, A. A. ; Secker Walker, L. M. ; Tricot, G. ; Van Den Berghe, H. ; Van Orshoven, A. ; Vuopio, P. ; Whang-Peng, Jacqueline. / Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia. In: Blood. 1986 ; Vol. 67, No. 2. pp. 415-420.
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abstract = "The importance of banded chromosome analyses in predicting long-term outcome in acute lymphoblastic leukemia (ALL) was evaluated in this follow-up study of 329 patients from the Third International Workshop on Chromosomes in Leukemia. Patients were divided into ten groups according to pretreatment karyotype: no abnormalities, one of the following structural abnormalities [the Philadelphia chromosome, translocations involving 8q24, t(4;11), 14q+, 6q-] or, in the remaining cases, model number [<46, 46, 47 to 50, > 50]. Achievement and duration of complete remission (CR) and survival differed among chromosome groups (P < .0001). Karyotype was an independent prognostic factor for duration of first CR and survival, even when age, initial leukocyte count (WBC), French-American-British (FAB) type, and immunologic phenotype were considered. Among adults, prolonged remission and survival were uncommon in all chromosome groups. Only in the normal karyotype group was median survival even two years. Among children, striking differences in long-term remission and survival were seen depending upon karyotype. Children in the > 50 group did best, with 70{\%} remaining in first CR for a median duration in excess of five years. Children in the 47-50, 6q-, and normal karyotype groups also had prolonged survivals. In contrast, certain translocations [t(9;22)(q34;q11), t(4;11)(q21;q14-23), t(8;14)(q24;q32)] identified children who had short survivals, even in the presence of favorable prognostic factors including a low WBC, L1 morphology, and non-T, non-B immunologic phenotype. We conclude that chromosome analysis is required at diagnosis in patients with ALL, and that children with these specific translocations should be managed as having high-risk ALL.",
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AU - Bloomfield, C. D.

AU - Goldman, A. I.

AU - Alimena, G.

AU - Berger, R.

AU - Borgström, G. H.

AU - Brandt, L.

AU - Catovsky, D.

AU - de la Chapelle, A.

AU - Dewald, G. W.

AU - Garson, O. M.

AU - Garwicz, S.

AU - Golomb, H. M.

AU - Hossfeld, D. K.

AU - Lawler, S. D.

AU - Mitelman, F.

AU - Nilsson, P.

AU - Pierre, R. V.

AU - Philip, P.

AU - Prigogina, E.

AU - Rowley, J. D.

AU - Sakurai, M.

AU - Sandberg, A. A.

AU - Secker Walker, L. M.

AU - Tricot, G.

AU - Van Den Berghe, H.

AU - Van Orshoven, A.

AU - Vuopio, P.

AU - Whang-Peng, Jacqueline

PY - 1986/6/3

Y1 - 1986/6/3

N2 - The importance of banded chromosome analyses in predicting long-term outcome in acute lymphoblastic leukemia (ALL) was evaluated in this follow-up study of 329 patients from the Third International Workshop on Chromosomes in Leukemia. Patients were divided into ten groups according to pretreatment karyotype: no abnormalities, one of the following structural abnormalities [the Philadelphia chromosome, translocations involving 8q24, t(4;11), 14q+, 6q-] or, in the remaining cases, model number [<46, 46, 47 to 50, > 50]. Achievement and duration of complete remission (CR) and survival differed among chromosome groups (P < .0001). Karyotype was an independent prognostic factor for duration of first CR and survival, even when age, initial leukocyte count (WBC), French-American-British (FAB) type, and immunologic phenotype were considered. Among adults, prolonged remission and survival were uncommon in all chromosome groups. Only in the normal karyotype group was median survival even two years. Among children, striking differences in long-term remission and survival were seen depending upon karyotype. Children in the > 50 group did best, with 70% remaining in first CR for a median duration in excess of five years. Children in the 47-50, 6q-, and normal karyotype groups also had prolonged survivals. In contrast, certain translocations [t(9;22)(q34;q11), t(4;11)(q21;q14-23), t(8;14)(q24;q32)] identified children who had short survivals, even in the presence of favorable prognostic factors including a low WBC, L1 morphology, and non-T, non-B immunologic phenotype. We conclude that chromosome analysis is required at diagnosis in patients with ALL, and that children with these specific translocations should be managed as having high-risk ALL.

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