期刊
JOURNAL OF CLINICAL ONCOLOGY
卷 26, 期 13, 页码 2186-2191出版社
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JCO.2007.14.3552
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资金
- NCI NIH HHS [CA 98543, P30 CA-21765, P30 CA021765, U10 CA098543, U10 CA098413, U10 CA029139, R21 CA-73983, CA 30969] Funding Source: Medline
Purpose To prospectively determine the prognostic significance of the TEL-AML1 fusion in children with acute lymphoblastic leukemia ( ALL). Patients and Methods TEL gene status was determined for 926 patients with B-precursor ALL enrolled on the Pediatric Oncology Group ALinC 16 trials and patients were observed for a median time of 8 years. Results Rearrangements of the TEL gene were detected in 244 patients (26%). The estimated 5-year event-free survival rate ( +/- SE) for patients with TEL rearrangements was 86% +/- 2%, compared with 72% +/- 2% for those with germline TEL ( P < .0001). TEL rearrangements were associated with a superior outcome among patients with standard-risk ALL, high-risk ALL, and rapid early responses to therapy. In a multivariate analysis that included risk group, sex, and day 15 marrow status, TEL status was an independent predictor of outcome ( P = .0002). Conclusion We conclude that TEL gene status should be incorporated into risk classification schemes and suggest that patients who have standard-risk features, the TEL-AML1 fusion, and rapid early responses to therapy, should be treated with antimetabolite-based therapy designed to maintain their high cure rates and avoid late effects.
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