Motlló Cristina, Ribera Josep-Maria, Morgades Mireia, Granada Isabel, Montesinos Pau, Mercadal Santiago, González-Campos José, Moreno María-José, Barba Pere, Cervera Marta, Barrios Manuel, Novo Andrés, Bernal Teresa, Hernández-Rivas Jesús-María, Abella Eugenia, Amigo María-Luz, Tormo Mar, Martino Rodrigo, Lavilla Esperanza, Bergua Juan, Serrano Alfons, García-Belmonte Daniel, Guàrdia Ramon, Grau Javier, Feliu Evarist
a Department of Hematology , ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Barcelona , Spain.
b Department of Hematology , Hospital Universitario y Politécnico La Fe , Valencia , Spain.
Leuk Lymphoma. 2018 Jan;59(1):146-154. doi: 10.1080/10428194.2017.1326596. Epub 2017 May 30.
About 25-35% of adult patients with acute lymphoblastic leukemia show the Philadelphia (Ph) chromosome. Few series have evaluated the prognosis of additional cytogenetic alterations (ACA) to the Ph chromosome. We analyzed the frequency, type and prognostic significance ofACA in adults (18-60 years) treated in the ALL-Ph-08 trial. Fifty-two out of 74 patients (70%) showed ACA and 19 (26%) presented monosomies associated with t(9;22) (monosomal karyotype, MK). Similar complete response (CR) rate, CR duration, overall survival and event-free survival (EFS) were observed in patients with or without ACA, but patients with MK showed shorter CR duration and EFS than the remaining. On multivariate analysis, the only variable with prognostic impact for CR duration and EFS was the presence of MK (p = .003 and p = .036, respectively). Although ACA associated with the Ph chromosome are frequent, only monosomies were associated with poor prognosis in this group of patients.
约25%-35%的成年急性淋巴细胞白血病患者存在费城（Ph）染色体。很少有系列研究评估Ph染色体之外其他细胞遗传学改变（ACA）的预后情况。我们分析了在ALL-Ph-08试验中接受治疗的18至60岁成年患者中ACA的频率、类型及预后意义。74例患者中有52例（70%）出现ACA，19例（26%）呈现与t(9;22)相关的单体性（单体核型，MK）。有或无ACA的患者观察到相似的完全缓解（CR）率、CR持续时间、总生存期和无事件生存期（EFS），但MK患者的CR持续时间和EFS比其余患者短。多因素分析显示，对CR持续时间和EFS有预后影响的唯一变量是MK的存在（分别为p = 0.003和p = 0.036）。尽管与Ph染色体相关的ACA很常见，但在这组患者中只有单体性与不良预后相关。
