High prevalence of <i>BCR‐ABL</i> fusion transcripts with poor prognostic impact among adult ALL patients: report from Pakistan

Faiz, Mariam; Iqbal, Qazi Javed; Qureshi, Muhammad Asif

doi:10.1111/j.1743-7563.2010.01370.x

Cited by 5 publications

(3 citation statements)

References 16 publications

(14 reference statements)

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“…Almost all Ph+ ALL cases have a precursor B-cell phenotype and most expressed CD19, CD10 and CD34 in our patients, which is similar to that reported elsewhere. 20 There was no difference in gender distribution between Ph+ and Ph-patients but the median age was signifi cantly higher in the Ph+ group (35-vs 25-year olds, P = 0.025). The Ph+ patients were also characterised by higher median haemoglobin levels (110.5 g/L vs 66.5 g/L, P = 0.001).…”

Section: Clinical and Biological Features Of Ph+ And Ph -Precursor B-...mentioning

confidence: 78%

“…No statistically signifi cant differences in initial CR rate, relapse rate and the median relapse were observed between Ph+ and Ph-groups and this was different from a previous study that BCR-ABL positivity is associated with a worse prognosis resulting from a lower initial CR rate and an earlier occurrence of relapse. 20 The presence of Ph chromosome in adults is associated with a very unfavourable prognosis. 9,36,37 Even though CR could be achievable with standard chemotherapy regimens, without an allogeneic stem cell transplant, cures are uncommon.…”

Section: Discussionmentioning

confidence: 99%

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Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients

Hai-xia

Wang

et al. 2014

Ann Acad Med Singap

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Introduction: This study sought to investigate the immunophenotypic subtype profiles of 110 Chinese adult patients with acute lymphoblastic leukaemia (ALL) and its association to cytogenetics and the clinical features. Materials and Methods: A total of 110 adult patients with ALL were immunophenotyped by CD45/SSC double parameters and 4 colour flow cytometry. Seventy-three cases were also subjected to karyotype analysis by R-banding technology. The clinical and laboratory data of 110 ALL patients were retrospectively analysed. Results: Of all the patients, 21.8% were identified as T-ALL, 78.2% as B-ALL. Abnormal karyotypes were detected in 37 out of 73 (50.7%) cases and the most common cytogenetic abnormality was the Philadelphia (Ph) chromosome, which was found in 23.3% (17/73) of the cases. Myeloid antigen (MyAg) expression was documented in 47.3% of the 110 adult ALL cases analysed and CD13 was the most commonly expressed MyAg in ALL patients (32.1 %). No difference was observed in the expression of MyAg between the groups of patients with T-ALL (45.8%) and B-ALL (47.7%). Our data showed that older age, higher CD34 positivity and lower proportion of patients with splenomegaly were found to be correlated with MyAg+ ALL, and that patients with Ph+ B-ALL were older, presented with higher haemoglobin level and higher CD34 expression. No statistical difference was noted in complete remission (CR) rate, relapse rate, induction mortality or total death rate among My+ and My-, Ph+ and Ph-, or B-ALL and T-ALL patients. Conclusion: Our results indicate that the distribution of ALL in Chinese adult patients was similar with the general distribution pattern in the other countries, and the expression of MyAg in patients with T-ALL and B-ALL was comparable. Both the expression of MyAg and the presence of Ph chromosome in adult ALL were significantly associated with median age and CD34 expression while not with the response to induction treatment. Key words: Biological characteristics, Cytogenetics, Immunophenotype

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Section: Clinical and Biological Features Of Ph+ And Ph -Precursor B-...mentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients

Hai-xia

Wang

et al. 2014

Ann Acad Med Singap

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“…Patients with Ph + ALL are mostly older, have high WBC count, are at risk of central nervous system involvement, and are more likely to relapse with chemotherapy alone (Faiz, Iqbal, & Qureshi, 2015). Therefore, allo-HSCT is recommended for patients with Ph + ALL who have achieved CR when possible.…”

Section: Discussionmentioning

confidence: 99%

Tyrosine Kinase Inhibitors and Reduced-Dose Chemotherapy for Adult Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

zeng

chen

et al. 2021

Preprint

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Purpose: To compare the outcomes of tyrosine kinase inhibitors in combination with reduced-dose chemotherapy with those of standard induction chemotherapy and to compare the outcomes between TKIs with chemotherapy regimen and transplantation in adults with Philadelphia chromosome-positive acute lymphoblastic leukemia Methods: We retrospectively reviewed all patients treated with tyrosine kinase inhibitors in combination with chemotherapy. These patients were divided into the TKIs with reduced-dose chemotherapy group (62 patients) and the TKIs with standard chemotherapy group (143 patients). In further treatment, patients were divided into the transplant group (55 patients) and the non-transplant group (143 patients).Results: The complete remission rate (88.7% vs 83.9%, P=0.372) and early mortality rate (3.2% vs 3.5%, P=0.922) were similar between the TKIs with reduced-dose chemotherapy group and the TKIs with standard chemotherapy group. The proportions of lung infection (P=0.047) and bloodstream infection (P=0.024) and the proportion of patients with >21 days of hospitalization (P<0.001), on >4 types of antibiotics (P=0.003), and on restrictive tigecycline and/or polymyxin (P=0.031) were higher in the standard chemotherapy group than in the TKIs with reduced-dose chemotherapy group. For cost analysis, the total costs and antimicrobial costs were higher in the standard chemotherapy group than in the TKIs with reduced-dose chemotherapy group. The 3-year overall survival rates and 3-year disease-free survival rates were significantly better in the transplant group than in the non-transplant group. Conclusion: An induction regimen combining TKIs with reduced-dose chemotherapy and transplantation in first CR remains a good option for patients with Ph+ALL.

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High Frequency and Poor Prognosis of Late Childhood BCR-ABL-Positive and MLL-AF4-Positive ALL Define the Need for Advanced Molecular Diagnostics and Improved Therapeutic Strategies in Pediatric B-ALL in Pakistan

et al. 2015

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This study reports the highest ethnic frequency of BCR-ABL FO in pediatric ALL, and is consistent with previous reports from our region. Poor prognosis BCR-ABL and MLL-AF4 was detected in two-thirds of pediatric B-ALL and is likely to be the reason for the already reported poor survival of childhood ALL in South-East Asia. Furthermore, MLL-AF4, usually most common in infants, presented in later childhood in most of the ALL patients, which was one of the unique findings in our study. The results presented here highlight the need for mandatory inclusion of molecular testing for pediatric ALL patients in clinical decision making, together with the incorporation of tyrosine kinase inhibitors, as well as hematopoietic stem cell transplantation facilities, to improve treatment outcome for patients in developing countries.

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High prevalence of BCR‐ABL fusion transcripts with poor prognostic impact among adult ALL patients: report from Pakistan

Abstract: A high prevalence of BCR-ABL gene fusion was observed that appeared as a poor prognostic factor. Identification of this genetic entity at diagnosis is crucial for understanding the nature of adult ALL and for deciding optimal treatment.

Cited by 5 publications

References 16 publications

Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients

Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients

Tyrosine Kinase Inhibitors and Reduced-Dose Chemotherapy for Adult Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

High Frequency and Poor Prognosis of Late Childhood BCR-ABL-Positive and MLL-AF4-Positive ALL Define the Need for Advanced Molecular Diagnostics and Improved Therapeutic Strategies in Pediatric B-ALL in Pakistan

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