CYTOGENETICS OF PRE-B-CELL ACUTE LYMPHOBLASTIC-LEUKEMIA WITH EMPHASIS ON PROGNOSTIC IMPLICATIONS OF THE T(1-19)
CYTOGENETICS OF PRE-B-CELL ACUTE LYMPHOBLASTIC-LEUKEMIA WITH EMPHASIS ON PROGNOSTIC IMPLICATIONS OF THE T(1-19)
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DOI：
10.1200/jco.1990.8.8.1380
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发表时间：
1990-08-01
影响因子：
45.3
通讯作者：
RIVERA, GK
中科院分区：
文献类型：
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作者：
RAIMONDI, SC;BEHM, FG;RIVERA, GK
在早期对前 B 细胞急性淋巴细胞白血病 (ALL) 儿童白血病淋巴细胞的细胞遗传学特征的研究中，我们得出结论，某些染色体异常在一定程度上解释了这种 ALL 免疫学亚类患者在诊断时高风险特征的增加以及对治疗反应较差的原因。随着随访时间的延长和患者群体的扩大，我们进一步评估了 B 期白血病的生物学和临床方面。在 686 例具有充分免疫表型的 ALL 病例中，150 例被归类为前 B 细胞。 112 例具有完全带状核型的 B 前期病例中，77 例 (69%) 发生易位。 t(1;19) 占这些 B 前病例中的 28 例 (25%)，占所有 480 例连续带状 ALL 病例中的 31 例 (6.5%)。三个 (2.6%) 的 B 前病例有一个新的双着丝粒 (7;9)(p1?3;p11) 易位。分别在七例 (6%) 和三例 (2.6%) 病例中观察到 t(9;22)(q34;q11) 和 t(4;11)(q21;q23)。在前 B 亚组中，将 t(1;19) 病例 (n = 28) 与具有其他易位 (n = 49) 或无可识别易位 (n = 35) 的病例进行比较表明，白细胞计数较高 (P = .002)、DNA 指数不大于 1.16 (P = .02)、血清乳酸脱氢酶水平较高 (P < .0001) 和较高的血清乳酸脱氢酶水平 (P < .0001)。非白人种族的频率 (P = .006) 与 t(1;19) 显着相关。 t(1;19) 和其他染色体易位均与 1979 年至 1984 年接受治疗的患者亚组的不良预后相关（全面治疗研究 X）。在最近的一项更强化的化疗方案（全面治疗研究 XI）中，t(1;19) 和其他染色体易位均未产生较差的结果，这表明有效的治疗可以抵消染色体重排对儿童前 B ALL 病例的负面影响。
In earlier studies of the cytogenetic characteristics of leukemic lymphoblasts from children from pre-B-cell acute lymphoblastic leukemia (ALL), we concluded that certain chromosomal abnormalities explain, in part, the increased presence of high-risk features at diagnosis and the less favorable response to therapy among patients with this immunologic subclass of ALL. With extended follow-up and a larger patient population, we have further evaluated the biologic and clinical aspects of pre-B leukemia. Of 686 cases of ALL with adequate immunophenotyping, 150 were classified as pre-B cell. Seventy-seven (69%) of the 112 pre-B cases with fully banded karyotypes had a translocation. The t(1;19) accounted for 28 (25%) of these pre-B cases and 31 (6.5%) of all 480 consecutively banded ALL cases. Three (2.6%) of the pre-B cases had a novel dicentric (7;9)(p1?3;p11) translocation. A t(9;22)(q34;q11) and a t(4;11)(q21;q23) were observed in seven (6%) and three (2.6%) of the cases, respectively. Within the pre-B subgroup, comparison of t(1;19) cases (n = 28) with those having other translocations (n = 49) or no identifiable translocations (n = 35) indicated that higher leukocyte counts (P = .002), absence of DNA indexes greater than 1.16 (P = .02), higher serum lactate dehydrogenase levels (P < .0001), and a higher frequency of nonwhite race (P = .006) were significantly related to the t(1;19). Both the t(1;19) and other chromosomal translocations were associated with an adverse prognosis in the subset of patients treated from 1979 to 1984 (Total Therapy study X). In a more recent and more intensive chemotherapy program (Total Therapy study XI), neither the t(1;19) nor other chromosomal translocations has conferred an inferior outcome, suggesting that effective treatment can offset the negative impact of chromosomal rearrangements in cases of childhood pre-B ALL.