Document Detail


Association of chromosome arm 9p abnormalities with adverse risk in childhood acute lymphoblastic leukemia: A report from the Children's Cancer Group.
MedLine Citation:
PMID:  10477677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cytogenetic abnormalities of chromosome arm 9p occur frequently in children with acute lymphoblastic leukemia (ALL). We analyzed 201 such cases (11%) in 1,839 children with newly diagnosed ALL treated between 1989 and 1995 on risk-adjusted protocols of the Children's Cancer Group (CCG). The majority of patients (131; 65%) with a 9p abnormality were classified as higher risk. Nearly all patients had complex karyotypes; most cases had deletions of 9p, add/der(9p), a dicentric involving chromosome arm 9p, and/or balanced translocations and inversions involving 9p. Event-free survival (EFS) estimates at 6 years for patients with and without a 9p aberration were 61% (standard deviation [SD] = 5%) and 76% (SD = 2%; P <.0001). In addition, patients with a 9p abnormality had an increased cumulative incidence of both marrow (P =.04) and central nervous system (P =.0001) relapses. Overall survival also was significantly worse for patients with an abnormal 9p (P <.0001). These effects were most pronounced in standard-risk patients (age 1 to 9 years with white blood cell count <50,000/microL): 6-year EFS of 61% (SD = 9%) versus 80% (SD = 2%; P <.0001). Also, a 9p aberration was an adverse risk factor for B-lineage, but not T-lineage patients. The effect of 9p status on EFS was attenuated, but maintained in a multivariate analysis of EFS after adjustment for Philadelphia chromosome status, age, white blood cell (WBC) count, sex, race, and ploidy group (P =.01). Thus, abnormalities of chromosome arm 9p identify a subgroup of standard-risk patients with increased risk of treatment failure.
Authors:
N A Heerema; H N Sather; M G Sensel; W Liu-Mares; B J Lange; B C Bostrom; J B Nachman; P G Steinherz; R Hutchinson; P S Gaynon; D C Arthur; F M Uckun
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Blood     Volume:  94     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-09-29     Completed Date:  1999-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1537-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Genetics, Hughes Institute, St Paul, MN, USA.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Chromosome Aberrations*
Chromosomes, Human, Pair 9*
Female
Humans
Infant
Male
Multivariate Analysis
Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*,  physiopathology
Risk Factors
Grant Support
ID/Acronym/Agency:
CA-13539/CA/NCI NIH HHS; CA-60437/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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