Poor prognosis of children with pre-B acute lymphoblastic leukemia is associated with the t(1;19) (q23;p13): A pediatric oncology group study

Academic Article

Abstract

  • The prognostic significance of chromosomal translocations, particularly t(1;19) (q23;p13), was evaluated in children with pre-B and early pre-B acute lymphoblastic leukemia (ALL). Patients were treated on a risk-based protocol of the Pediatric Oncology Group (POG) between February 1986 and May 1989. An abnormal clone was detected in 46% (130 of 285) of pre-B cases and 56% (380 of 679) of early pre-B cases. Translocation of any type was associated with a worse treatment outcome than other karyotypic abnormalities: 15 of 66 versus 3 of 64 failed therapy in the pre-B group (P = .001), and 37 of 141 versus 23 of 239 failed in the early pre-B group (P < .001). The t(1;19) (q23;p13) occurred significantly more ofen in cases of pre-B ALL with a clonal abnormality than in early pre-B ALL cases (29 of 130 v 5 of 380, P < .001). Among the 285 pre-B cases in which bone marrow was studied cytogenetically, those with t(1;19) had a significantly worse treatment outcome than all others (11 of 29 v 27 of 256 have failed therapy, P < .001). This difference is significant (P < .001) after adjustment for leukocyte count, age, and other relevant features. Cases with the t(1;19) also had a worse prognosis than pre-B patients with other translocations (4 of 37 have failed, P < .01) or with any other karyotypic abnormality (7 of 101 have failed, P < .001). We conclude that chromosomal translocations confer a worse prognosis for non-T, non-B-cell childhood ALL, and that the t(1;19) is largely responsible for the poor prognosis of the pre-B subgroup.
  • Published In

  • Blood  Journal
  • Digital Object Identifier (doi)

    Author List

  • Crist WM; Carroll AJ; Shuster JJ; Behm FG; Whitehead M; Vietti TJ; Look AT; Mahoney D; Ragab A; Pullen DJ
  • Start Page

  • 117
  • End Page

  • 122
  • Volume

  • 76
  • Issue

  • 1