Haematologica
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Published online 26 January 2008
Haematologica, Vol 93, Issue 2, 287-290 doi:10.3324/haematol.11891
Copyright © 2008 by Ferrata Storti Foundation
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Acute Lymphoblastic Leukemia

Karyotype at diagnosis is the major prognostic factor predicting relapse-free survival for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib-combined chemotherapy

Masamitsu Yanada1,, Jin Takeuchi2, Isamu Sugiura3, Hideki Akiyama4, Noriko Usui5, Fumiharu Yagasaki6, Kazuhiro Nishii7, Yasunori Ueda8, Makoto Takeuchi9, Shuichi Miyawaki10, Atsuo Maruta11, Hiroto Narimatsu1, Yasushi Miyazaki12, Shigeki Ohtake13, Itsuro Jinnai6, Keitaro Matsuo14, Tomoki Naoe1, Ryuzo Ohno14 for the Japan Adult Leukemia Study Group

1 From the Nagoya University Graduate School of Medicine, Nagoya;
2 Nihon University School of Medicine, Tokyo;
3 Toyohashi Municipal Hospital, Toyohashi;
4 Tokyo Metropolitan Komagome Hospital, Tokyo;
5 Jikei University School of Medicine, Tokyo;
6 Saitama Medical University, Saitama;
7 Mie University School of Medicine, Tsu;
8 Kurashiki Central Hospital, Kurashiki;
9 National Hospital Organization Minami-Okayama Medical Center, Okayama;
10 Saiseikai Maebashi Hospital, Maebashi;
11 Kanagawa Cancer Center, Yokohama;
12 Nagasaki University Graduate School of Biomedical Sciences, Nagasaki;
13 Kanazawa University Graduate School of Medical Science, Kanazawa;
14 Aichi Cancer Center, Nagoya, Japan

Correspondence: Masamitsu Yanada, MD, Department of Leukemia, Unit 428, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030, USA. E-mail: myanada{at}mdanderson.org

To identify factors associated with relapse-free survival (RFS), 80 patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia, enrolled in a phase II study of imatinib-combined chemotherapy, were analyzed. The median follow-up of surviving patients was 26.7 months (maximum, 52.5 months). Twenty-eight out of 77 patients who had achieved CR relapsed. The probability of RFS was 50.5% at 2 years. Multivariate analysis revealed that the presence of secondary chromosome aberrations in addition to t(9;22) at diagnosis constitute an independent predictive value for RFS (p=0.027), and increase the risk of treatment failure by 2.8-fold.

Key words: acute lymphoblastic leukemia, Philadelphia chromosome, BCR-ABL, imatinib, karyotype.






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