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Cancer. 2015 Nov 1;121(21):3809-17. doi: 10.1002/cncr.29579. Epub 2015 Jul 20.

Prognostic significance of copy number alterations in adolescent and adult patients with precursor B acute lymphoblastic leukemia enrolled in PETHEMA protocols.

Author information

1
Clinical Hematology Department, Catalan Institute of Oncology at Germans Trias i Pujol Hospital, Jose Carreras Leukemia Research Institute, Autonomous University of Barcelona, Badalona, Spain.
2
Hematology Department, La Fe Hospital, Valencia, Spain.
3
Hematology Department, Hospital Clinic, August Pi i Sunyer Institute for Biomedical Research, Barcelona, Spain.
4
Hematology Department, Catalan Institute of Oncology at Duran i Reynals Hospital, Hospitalet de Llobregat, Spain.
5
Hematology Department, Catalan Institute of Oncology at Josep Trueta Hospital, Girona, Spain.
6
Hematology Department, Hospital de Sant Pau, Barcelona, Spain.
7
Hematology Department, Hospital Clínico, Valencia, Spain.
8
Hematology Department, Doce de Octubre Hospital, Madrid, Spain.
9
Hematology Department, Institute of Biomedical Investigation of Salamanca, Institute of Molecular and Cellular Biology of Cancer, Center of Investigation of Cancer, Spanish National Research Council at University of Salamanca, Hospital Clínico Universitario, Salamanca, Spain.
10
Hematology Department, Vírgen del Rocío Hospital, Seville, Spain.
11
Hematology Department, Vall d'Hebron Hospital, Barcelona, Spain.
12
Hematology Department, Joan XXIII University Hospital, Tarragona, Spain.

Abstract

BACKGROUND:

Some copy number alterations (CNAs) have independent prognostic significance for adults with acute lymphoblastic leukemia (ALL).

METHODS:

This study analyzed via multiplex ligation-dependent probe amplification the frequency and prognostic impact of CNAs of 12 genetic regions in 142 adolescents and adults with de novo precursor B-cell ALL.

RESULTS:

The cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletion (59 of 142 or 42%) was the most frequent CNA, and it was followed by Ikaros family zinc finger 1 (IKZF1) losses (49 of 142 or 35%). IKZF1 deletions were more prevalent in Philadelphia chromosome (Ph)-positive ALL and were associated with advanced age and high white blood cell (WBC) counts. The multivariate analysis showed that advanced age and early B-cell factor 1 (EBF1) deletions were associated with chemotherapy resistance in both the whole series (hazard ratios, 0.949 and 0.135, respectively) and the Ph-negative subgroup (hazard ratios, 0.946 and 0.118, respectively). High WBC counts and focal IKZF1 deletions correlated with disease recurrence (hazard ratios, 1.005 and 1.869, respectively), whereas advanced age and CDKN2A/B losses influenced overall survival in both the whole series (hazard ratios, 1.038 and 2.545, respectively) and the Ph-negative subgroup (hazard ratios, 1.044 and 2.105, respectively).

CONCLUSIONS:

Deletions of EBF1, IKZF1, and CDKN2A/B have an independent adverse prognosis for adolescents and adults with B-precursor ALL, and this suggests that these CNAs should be included in the initial risk assessment of ALL.

KEYWORDS:

B precursor; acute lymphoblastic leukemia; adult; copy number alterations; prognosis

PMID:
26194343
DOI:
10.1002/cncr.29579
[Indexed for MEDLINE]
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