Non-inferior long-term outcomes of adults with Philadelphia chromosome-like acute lymphoblastic leukemia

Cho, Hanwool; Kim, Yonggoo; Yoon, Jihyun; Lee, Jaewoong; Lee, Gun Dong; Son, Jungok; Han, Kyungja; Lee, Seok; Kim, Myungshin

doi:10.1038/s41409-021-01253-6

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…These factors include the MRD status, presence of CRLF2 , IKAROS family zinc finger 1, and JAK2 rearrangements, and availability of modern salvage therapies. Studies by Cho et al [59] indicate that allogenic HSCT in BCR/ABL1 -like ALL patients contributes to improved outcomes. The role of post-HSCT maintenance therapy with TKI in MRD-persistent patients remains debatable.…”

Section: Molecularly Targeted Therapy In Bcr/abl1-like Allmentioning

confidence: 99%

BCR/ABL1-Like Acute Lymphoblastic Leukemia: From Diagnostic Approaches to Molecularly Targeted Therapy

Płotka

Lewandowski²

2021

Acta Haematol

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Background: BCR/ABL1-like acute lymphoblastic leukemia is a newly recognized high-risk subtype of ALL, characterized by the presence of genetic alterations activating kinase and cytokine receptor signaling. This subtype is associated with inferior outcomes, compared to other B-cell precursor ALL. Summary: The recognition of BCR/ABL1-like ALL is challenging due to the complexity of underlying genetic alterations. Rearrangements of CRLF2 are the most frequent alteration in BCR/ABL1-like ALL and can be identified by flow cytometry. The identification of BCR/ABL1-like ALL can be achieved with stepwise algorithms or broad-based testing. The main goal of the diagnostic analysis is to detect the underlying genetic alterations, which are critical for the diagnosis and targeted therapy. Key Messages: The aim of the manuscript is to review the available data on BCR/ABL1-like ALL characteristics, diagnostic algorithms, and novel, molecularly targeted therapeutic options.

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Section: Molecularly Targeted Therapy In Bcr/abl1-like Allmentioning

confidence: 99%

BCR/ABL1-Like Acute Lymphoblastic Leukemia: From Diagnostic Approaches to Molecularly Targeted Therapy

Płotka

Lewandowski²

2021

Acta Haematol

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“…Finally, allo-HSCT remains crucial for achieving favorable survival outcomes for Ph-like ALL. 26,27 In this study, allo-HSCT was associated with improved outcomes in patients within the HR subgroup of Ph-like ALL. However, given that the small numbers of patients (n = 26) included in the analysis, these findings should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 68%

An integrated classification of tumor suppressor IKZF1 inactivation and oncogenic activation in Philadelphia chromosome‐like acute lymphoblastic leukemia

Huang,

Zhang,

Gong

et al. 2024

HemaSphere

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Philadelphia chromosome (Ph)‐like acute lymphoblastic leukemia (ALL) is recognized for its genetic and clinical diversity. In this study, we identified a novel high‐risk subset of Ph‐like ALL, characterized by the activation of oncogenic signaling and the inactivation of the tumor suppressor gene IKZF1, resulting in a dismal outcome. The association between cytogenetic aberrations and clinical features was assessed on a cohort of 191 patients with Ph‐like ALL. Our findings revealed that patients with inactivation of IKZF1 combined with activation of oncogenic signaling (CRLF2/EPOR/JAK2 rearrangements or p‐CRKL/p‐STAT5 high expression) had the worst outcome (3‐year overall survival [OS] of 28.8% vs. 80.1% for others, p < 0.001; 2‐year event‐free survival [EFS] of 6.5% vs. 57.0% for others, p < 0.001). Multivariable analysis demonstrated that this high‐risk feature was an independent inferior prognostic factor (adjusted hazard ratio for OS = 4.55, 95% confidence interval [CI]: 2.35–8.81, p < 0.001; adjusted hazard ratio for EFS = 3.27, 95% CI: 1.99–5.39, p < 0.001). Allogeneic hematopoietic stem cell transplantation was associated with improved prognoses in patients within the high‐risk subgroup. In conclusion, this study identified a clinically distinct entity that possesses effective prognostic features and provides potential guidance for refining risk stratification in Ph‐like ALL.

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“…We used data from the Clinical Data Warehouse (CDW) database, which is a large, integrated, harmonized database of five tertiary referral medical centers belonging to The Catholic University of Korea, College of Medicine, Seoul, Korea 27 . The information in this database has been collected from electronic medical records (EMR) and order communication system (OCS) since April 1997, the platforms of which are commonly shared by the five hospitals.…”

Section: Methodsmentioning

confidence: 99%

The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

Kim

Song

et al. 2021

Sci Rep

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We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.

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Non-inferior long-term outcomes of adults with Philadelphia chromosome-like acute lymphoblastic leukemia

Cited by 15 publications

References 30 publications

<b><i>BCR/ABL1</i></b>-Like Acute Lymphoblastic Leukemia: From Diagnostic Approaches to Molecularly Targeted Therapy

<b><i>BCR/ABL1</i></b>-Like Acute Lymphoblastic Leukemia: From Diagnostic Approaches to Molecularly Targeted Therapy

An integrated classification of tumor suppressor IKZF1 inactivation and oncogenic activation in Philadelphia chromosome‐like acute lymphoblastic leukemia

The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

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