Purpose
Recent cooperative trials in pediatric acute lymphoblastic leukemia (ALL) report long-term event-free survival (EFS) of greater than 80%. In this study, we analyzed the outcome and prognostic factors for patients with precursor B cell ALL (n=405) diagnosed during a 10-year period (2005-2015) at our institution.
Materials and Methods
All patients were treated with a uniform institutional regimen based on four risk groups, except for steroid type; patients diagnosed up till 2008 receiving dexamethasone, while subsequent patients received prednisolone. None of the patients received cranial irradiation in first complete remission.
Results
The 10-year EFS and overall survival was 76.3%±2.3% and 85.1%±1.9%. Ten-year cumulative incidence of relapse, any central nervous system (CNS) relapse and isolated CNS relapse was 20.8%±2.2%, 3.7%±1.1% and 2.5%±0.9% respectively. A comparison of established, good prognosis genetic abnormalities showed that patients with high hyperdiploidy had significantly better EFS than those with ETV6-RUNX1 rearrangement (10-year EFS of 91.2%±3.0% vs. 79.5%±4.4%, p=0.033). For the overall cohort, male sex, infant ALL, initial CNS involvement, and Philadelphia chromosome (+) ALL were significant factors for lower EFS in multivariate study, while high hyperdiploidy conferred favorable outcome. For high and very high risk patients (n=231), high hyperdiploidy was the only significant factor for EFS in multivariate study.
Conclusion
Regarding good prognosis genetic abnormalities, patients with high hyperdiploidy had significantly better outcome than ETV6-RUNX1 (+) patients. High hyperdiploidy was a major, favorable prognostic factor in the overall patient group, as well as the subgroup of patients with higher risk.
Citations
Citations to this article as recorded by
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PURPOSE To evaluate the possible role of DNA content abnomrality in solid tumors as a diagnostic indicator in Korean patients, the incidence of aneuploidy in the major organs were analyzed and compared with the incidences which have been reported in the literatures. MATERIALS AND METHODS Flow cytometric analysis of DNA content were performed on the 1673 fresh tissues of neoplastic lesions which were obtained for the last five years in Hospital. RESULTS The frequency of aneuploidy was more than 50% in the primary malignant tumors of the stomach, colon, esophagus, liver, biliary tract, pancreas, head and neck organs, salivary gland, lung, breast, ovary, CNS and urinary tract. However, the frequency of aneuploidy was as low as 7% in papillary carcinoma of thyroid and about 30% in renal cell carcinoma and malignant lymphomas. High frequency of aneuploidy (more than 70%) was seen in the metastatic tumors in liver, brain, ovary and lymph nodes. Aneuploidy was also found in benign tumors of salivary gland, adenomas of endocrine organs, meningiomas, smooth muscle tumors and schwannomas. CONCLUSION The results of present study were in concordant with those of the other domestic and foreign studies.
Although aneuploidy can be observed in some benign tumors, DNA ploidy pattern is considered to be an important diagnostic and prognostic factors in malignant lesions of the various organs.