To elucidate the biologic and clinical heterogeneity of adult pro-B acute lymphoblastic leukemia (ALL) (ie, terminal deoxynucletidyl-transferase-positive[TdT+], CD19+, CD10-, surface immunoglobulin-negative [SIg-]), we evaluated 66 patients enrolled in the Italian multicentric Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) 0496 study between October 1996 and December 1999. The ALL1/AF4 fusion transcript, originating from the t(4;11) translocation, was detected in 24 patients (36.4%), and the BCR/ABL chimeric product was found in 6 patients (9%), while the remaining 36 cases (54.6%) were ALL1/AF4-BCR/ABL-negative. A white blood cell (WBC) count higher than 50 x 109/L was found in 13 of 24, 2 of 6, and 6 of 36 of the ALL1/AF4-positive, BCR/ABL-positive, and ALL1/AF4-BCR/AB-negative patients, respectively (P =.007). None of the 24 ALL1/AF4-positive patients coexpressed the CD13 and/or CD33 myeloid antigens. By contrast, CD13 and CD33 molecules were detected, respectively, in 3 of 6 and in 14 of 33 cases of the BCR/ABL-positive patient group, and in 2 of 6 and 9 of 35 cases of the ALL1/AF4-BCR/ABL-negative patient group. These differences still remained statistically significant even if the BCR/ABL-positive patients were excluded from the analysis. A complete remission (CR) was achieved in 52 (83.4%) of the 62 patients with ALL evaluable for response to treatment. CR rates were similar in the 3 genotypic groups. By contrast, comparing patients with or without the ALL1/AF4 gene the probability of remaining in continuous complete remission (CCR) at 3.5 years was 16% and 49.8%, respectively (P =.005). Our data demonstrate that in adult pro-B-ALL a distinction should be made between pro-B-ALL cases with and without the ALL1/AF4 or the BCR/ABL chimeric genes, since the absence of both of these fusion genes correlates with a significantly better clinical outcome after intensive polychemotherapy treatment without hematopoietic stem cell transplantation.

Clinico-biologic features and treatment outcome of adult pro-B ALL enrolled in the GIMEMA 0496 study: absence of the ALL/AF4 and BCR/ABL fusion genes correlates with a significanntly better clinical outcome / Cimino, Giuseppe; Elia, L.; Mancini, M.; Annino, L.; Anaclerico, B.; Fazi, P.; Vitale, A.; Specchia, G.; DI RAIMONDO, F.; Recchia, A.; Cuneo, A; Mecucci, C.; Pane, F.; Saglio, G.; Foa, Roberto; MANDELLI F., FOR THE GIMEMA GROUP. - In: BLOOD. - ISSN 0006-4971. - 102:6(2003), pp. 2014-2020. [10.1182/blood-2002-12-3822]

Clinico-biologic features and treatment outcome of adult pro-B ALL enrolled in the GIMEMA 0496 study: absence of the ALL/AF4 and BCR/ABL fusion genes correlates with a significanntly better clinical outcome.

CIMINO, Giuseppe;FOA, Roberto;
2003

Abstract

To elucidate the biologic and clinical heterogeneity of adult pro-B acute lymphoblastic leukemia (ALL) (ie, terminal deoxynucletidyl-transferase-positive[TdT+], CD19+, CD10-, surface immunoglobulin-negative [SIg-]), we evaluated 66 patients enrolled in the Italian multicentric Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) 0496 study between October 1996 and December 1999. The ALL1/AF4 fusion transcript, originating from the t(4;11) translocation, was detected in 24 patients (36.4%), and the BCR/ABL chimeric product was found in 6 patients (9%), while the remaining 36 cases (54.6%) were ALL1/AF4-BCR/ABL-negative. A white blood cell (WBC) count higher than 50 x 109/L was found in 13 of 24, 2 of 6, and 6 of 36 of the ALL1/AF4-positive, BCR/ABL-positive, and ALL1/AF4-BCR/AB-negative patients, respectively (P =.007). None of the 24 ALL1/AF4-positive patients coexpressed the CD13 and/or CD33 myeloid antigens. By contrast, CD13 and CD33 molecules were detected, respectively, in 3 of 6 and in 14 of 33 cases of the BCR/ABL-positive patient group, and in 2 of 6 and 9 of 35 cases of the ALL1/AF4-BCR/ABL-negative patient group. These differences still remained statistically significant even if the BCR/ABL-positive patients were excluded from the analysis. A complete remission (CR) was achieved in 52 (83.4%) of the 62 patients with ALL evaluable for response to treatment. CR rates were similar in the 3 genotypic groups. By contrast, comparing patients with or without the ALL1/AF4 gene the probability of remaining in continuous complete remission (CCR) at 3.5 years was 16% and 49.8%, respectively (P =.005). Our data demonstrate that in adult pro-B-ALL a distinction should be made between pro-B-ALL cases with and without the ALL1/AF4 or the BCR/ABL chimeric genes, since the absence of both of these fusion genes correlates with a significantly better clinical outcome after intensive polychemotherapy treatment without hematopoietic stem cell transplantation.
2003
01 Pubblicazione su rivista::01a Articolo in rivista
Clinico-biologic features and treatment outcome of adult pro-B ALL enrolled in the GIMEMA 0496 study: absence of the ALL/AF4 and BCR/ABL fusion genes correlates with a significanntly better clinical outcome / Cimino, Giuseppe; Elia, L.; Mancini, M.; Annino, L.; Anaclerico, B.; Fazi, P.; Vitale, A.; Specchia, G.; DI RAIMONDO, F.; Recchia, A.; Cuneo, A; Mecucci, C.; Pane, F.; Saglio, G.; Foa, Roberto; MANDELLI F., FOR THE GIMEMA GROUP. - In: BLOOD. - ISSN 0006-4971. - 102:6(2003), pp. 2014-2020. [10.1182/blood-2002-12-3822]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/32167
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