| Prognostic implications of breakpoint and lineage heterogeneity in Philadelphia-positive acute lymphoblastic leukemia: a review. | |
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MedLine Citation:
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PMID: 8426467 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Philadelphia-positive (Ph) acute lymphoblastic leukemia (ALL) is heterogeneous both in terms of the BCR gene breakpoints (M-bcr and m-bcr) and in the number of cell lineages carrying the Ph chromosome. The impact of these observations on the controversy surrounding Ph ALL and Ph+ chronic granulocytic leukemia (CGL) is unclear. Twenty cases of Ph ALL (four newly investigated and 16 previously published) were classified into nine stem-cell (the Ph in myeloid and lymphoid cells) and 11 lymphoid-restricted cases. Lymphoid cases had a lower leucocyte count (56 x 10(9)/l) than stem-cell cases (151 x 10(9)/l) (p < 0.01). The M-bcr and m-bcr breakpoints (in 14 cases) were found in lymphoid (four cases of each) and stem-cell (five and one cases respectively) cases. Lymphoid cases had significantly shorter event-free survival (median 4 months) than stem-cell cases (median 35 months) (p < 0.01). M-bcr cases were older (mean 41 years) than m-bcr cases (mean 36 years)(p = NS); m-bcr cases had higher leukocyte counts (mean 85 x 10(9)/l) than M-bcr cases (36 x 10(9)/l)(p < 0.01) but breakpoint had no impact on prognosis. Lineage involvement, but not breakpoint, appears to distinguish prognostically important sub-groups of Ph ALL. Paradoxically, lymphoid-restricted cases have a worse prognosis than cases arising in a pluripotent stem-cell. |
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Authors:
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L M Secker-Walker; J M Craig |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Leukemia Volume: 7 ISSN: 0887-6924 ISO Abbreviation: Leukemia Publication Date: 1993 Feb |
Date Detail:
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Created Date: 1993-03-01 Completed Date: 1993-03-01 Revised Date: 2013-03-04 |
Medline Journal Info:
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Nlm Unique ID: 8704895 Medline TA: Leukemia Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 147-51 Citation Subset: IM |
Affiliation:
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Department of Haematology, Royal Free Hospital and School of Medicine, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Blast Crisis / genetics, pathology Child Child, Preschool Chromosomes, Human, Pair 22* Chromosomes, Human, Pair 9* Female Humans Immunophenotyping Infant Karyotyping Male Middle Aged Neoplastic Stem Cells / pathology* Philadelphia Chromosome* Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*, mortality, pathology Prognosis Survival Analysis Translocation, Genetic / genetics* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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