Cytogenetics of acute lymphoblastic leukaemia in children as a factor in the prediction of long‐term survival

Abstract

A chromosomal classification of 93 children with acute lymphoblastic leukaemia (ALL) is presented. The chromosomal categories were normal, hyperdiploid, pseudodiploid and hypodiploid: the chromosomally abnormal cases were classified according to the presence of an abnormal clone. The longest follow-up was 9 years. Infants and older children were over-represented in the pseudodiploid category: this association was statistically significant. Patients in the hyperdiploid and hypodiploid categories had the longest first remissions and overall survival and those in the pseudodiploid category the shortest. These effects were statistically significant even when the effect of age and leucocyte count were taken into account. Thus chromosomal findings at diagnosis in ALL can be used as an independent prognostic factor.

Prognostic cytogenetic markers in childhood acute lymphoblastic leukemia

“…5,31,34,35 So, the authrs recommend the use of these techniques as well as Flowcytometry for more accurate characterization of patient ploidy pattern and hence better prognostication. Hypodiploid cases were found to represent 37.5% of the cases in the present study; higher than previous reports in Egypt (22.5%) 33 and that reported by others who considered hypodiploidy to be a relatively uncommon finding in ALL (only 3% -9% of all cases) 32,36,37,38 In the current study as well as the previous series, 33 hyperdiploid represented a minority of ALL cases although other authors have reported higher frequency. 31,39 The best remission rate in the present study cases was achieved among hypodiploid followed by pseudodiploid and hyperdiploid but the normal diploid cases were the worst (73.3%, 70%, 57.1% and 37.5% respectively).…”

Detection of minimal residual disease in acute leukemia by flow cytometry

“…For example, children with ALL who have genetic features such as the chromosomal translocation t (9;22) or rearrangements of the MLL gene respond poorly to chemotherapy (2); often, bone marrow transplantation is the only curative option for these patients. Conversely, children whose leukemic blast cells contain 51 to 65 chromosomes or TEL rearrangements respond consistently well to chemotherapy (11,12). Similar distinctions have been delineated in AML: cases with 16q22 abnormalities, t (15;17), or t(8;21) have a more favorable prognosis than those with 11q, 5q or 7q abnormalities or hypodiploidy (13).…”

Prospective study of childhood acute lymphocytic leukemia: Hematologic, immunologic, and cytogenetic correlations

“…There is now evidence that cytogenetic abnormalities can be detected in 60-94 % of children with ALL [8,9]. Other studies have shown significant correlation between karyotypic abnormalities and prognosis, but with the exception of the study by Williams et al [9], there have been no single-institution patient studies using the same treatment regimens.…”