期刊
CANCER
卷 121, 期 21, 页码 3809-3817出版社
WILEY
DOI: 10.1002/cncr.29579
关键词
acute lymphoblastic leukemia; adult; B precursor; copy number alterations; prognosis
类别
资金
- Health Research Fund [PI10/01417, PI14/01971]
- Cancer Cooperative Research Thematic Network/Spanish Federation of Rare Diseases [RD12/0036/0029, RD/0036/044]
- Carlos III Institute of Health
- Spanish Ministry of Economy and Competitiveness
- Spanish Society of Hematology and Hemotherapy
- Government of Catalonia [2014 SGR 225-GRE]
- International Josep Carreras Foundation
- Obra Social La Caixa
BACKGROUNDSome copy number alterations (CNAs) have independent prognostic significance for adults with acute lymphoblastic leukemia (ALL). METHODSThis study analyzed via multiplex ligation-dependent probe amplification the frequency and prognostic impact of CNAs of 12 genetic regions in 142 adolescents and adults with de novo precursor B-cell ALL. RESULTSThe cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletion (59 of 142 or 42%) was the most frequent CNA, and it was followed by Ikaros family zinc finger 1 (IKZF1) losses (49 of 142 or 35%). IKZF1 deletions were more prevalent in Philadelphia chromosome (Ph)-positive ALL and were associated with advanced age and high white blood cell (WBC) counts. The multivariate analysis showed that advanced age and early B-cell factor 1 (EBF1) deletions were associated with chemotherapy resistance in both the whole series (hazard ratios, 0.949 and 0.135, respectively) and the Ph-negative subgroup (hazard ratios, 0.946 and 0.118, respectively). High WBC counts and focal IKZF1 deletions correlated with disease recurrence (hazard ratios, 1.005 and 1.869, respectively), whereas advanced age and CDKN2A/B losses influenced overall survival in both the whole series (hazard ratios, 1.038 and 2.545, respectively) and the Ph-negative subgroup (hazard ratios, 1.044 and 2.105, respectively). CONCLUSIONSDeletions of EBF1, IKZF1, and CDKN2A/B have an independent adverse prognosis for adolescents and adults with B-precursor ALL, and this suggests that these CNAs should be included in the initial risk assessment of ALL. Cancer 2015;121:3809-3817. (c) 2015 American Cancer Society. Deletions of early B-cell factor 1, cyclin-dependent kinase inhibitor 2A/B, and Ikaros family zinc finger 1 are independent markers of a poor prognosis for uniformly treated adolescent and adult patients with B precursor acute lymphoblastic leukemia.
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