Newly diagnosed acute lymphoblastic leukemia in China (II): prognosis related to genetic abnormalities in a series of 1091 cases

Abstract

The molecular characterization of cytogenetic abnormalities has not only provided insights into the mechanisms of leukemogenesis but also led to the establishment of new treatment strategies targeting these abnormalities and thereby further improve the prognosis of patients. We analyzed the prognosis of 1091 Chinese patients with newly diagnosed acute lymphoblastic leukemia (ALL) and explored the prognostic impacts of a large number of cytogenetic/molecular abnormalities. It was demonstrated that, in both B-and T-ALL settings, the prognosis was negatively correlated to the age as reported to date. For childhood T-ALL patients, it was also documented that the HOX11 expression represented a favorable prognostic factor as it was in adult ones. We identified CRLF2 overexpression as an intermediate-risk marker and Ik6 variant of IKZF1 gene as a high-risk one when stratifying pediatric B-ALL cases according to cytogenetic/molecular risks. We also found that Ik6 variant and CRLF2 overexpression had an important role in dictating the prognosis of Ph-negative patients, which may be useful markers in guiding the treatment of ALL in the future, with tyrosine kinase inhibitors on the other hand reversing the fate of Ph-positive ALL patients.

Clinical characteristics of acute lymphoblastic leukemia in male and female patients: A retrospective analysis of 705 patients

“…The present finding of the gender ratio indicated a male predominance, which is consistent with previous studies of Chinese ALL patients (3,4,(8)(9)(10)(11)(17)(18)(19)(20)(21). As shown in Table II, the gender ratio of ALL patients from various areas of China ranged between 1.37 (20) and 1.92 (3), indicating that regional differences exerted a minor influence on the gender predominance.…”

“…The majority of previous studies on Chinese patients conveyed limited data regarding gender difference (4,(8)(9)(10)(11). In addition, the patients in these studies were from Northern China, such as Beijing (12), Eastern China, such as Shanghai (5,6,(9)(10)(11), and central China, such as Wuhan (10).…”

ENO2 Promotes Cell Proliferation, Glycolysis, and Glucocorticoid-Resistance in Acute Lymphoblastic Leukemia

“…Clinical trials for these patients have slightly improved the cure rate of this disease [11, 12]. Ph/BCR-ABL was known as a high-risk prognostic factor, but the emergence of tyrosine kinase inhibitors has significantly improved CR rates and the outcome of Ph-positive ALL patients [13, 14]. Some genes, such as LKB1, PTEN and PI3K/AKT and RAS, have been implicated in regulating the energy metabolism or as part of the process of glycolysis [15, 16].…”

Acute Lymphoblastic Leukemia, Version 2.2015

“…IKZF1 mutations are seen in approximately 15% to 20% of pediatric B-cell ALL 49,50 and at a higher frequency of more than 75% in patients who are also BCR-ABL positive. 45,50 Incidence in adults is about 50% in B-cell ALL 51,52 and about 65% when also BCR-ABL positive. 53,54 A study evaluating the relationship between BCR-ABL1-like and IKZF1 in children with B-cell precursor ALL showed that 40% of cases had cooccurrence of these mutations.…”