Publication Date:
2004-11-16
Description:
Background: In pediatric B-precursor acute lymphoblastic leukemia (ALL), hyperdiploidy (51 to 65 chromosomes and/or DNA index 〉 1.16) comprises approximately 25% of cases and is associated with a favorable prognosis. Aim: To evaluate the clinical and relapse characteristics of children with hyperdiploid (HY) ALL treated at Children’s Hospital of Michigan from 1991 to 2002. Methodology: Children were treated per several successive Pediatric Oncology Group ALL studies. Data was obtained by retrospective chart review. Study end-points were "relapse" or "death" whichever came first. Univariate and multivariate analysis was performed to study the association of various clinical and biological factors on outcome. Survival curves were drawn using Log-rank test. Results: 139 children diagnosed with ALL were included in the study: 31 (22%) HY-ALL; 108 (88%) non-HY-ALL (Table). In HY-ALL, 11(35%) relapsed: 3 (27%) isolated hematopoietic (HEM); 8 (73%) extra-medullary (EM) [TESTES: 4; TESTIS+HEM: 1; CNS+HEM: 3]. Two (18%) relapsed while on treatment. Non-HY-ALL relapses occurred in 25 (23%): HEM 16 (64%); EM 9 (46%) [TESTIS: 1; TESTIS+HEM: 1; CNS: 6; CNS+HEM: 1]. Thus, HY-ALL children were predisposed to EM involvement at relapse compared to non-HY-ALL (p10 years and Caucasian race were associated with poor EFS (p10 yr) with HY-ALL may require more intensive treatment and monitoring of sanctuary sites to prevent treatment failures. Figure Figure Patient Characterisitcs at Diagnosis Patient characterisitcs Hyperdiploid ALL (n=31) Non-Hyperdiploid ALL (n=108) CAUC: Caucasian; AA: African American; O: Other Median age (yrs) 3.9 (1.3–16.0) 5.8 (3.0–17.0) Race: CAUC/AA/O 21(69%)/ 6(19%)/ 4(12%) 66(61%)/ 28(26%)/ 14(12%) Age〉10 yr 5 (16%) 13 (12%) Male:Female 20 (65%):11(35%) 58 (54%):50(46%) Median follow up (yrs) 5.9 ± 4.0 5.3 ±3.4 Events 11 (35%) 30 (28%)
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
Permalink