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Philadelphia positive acute lymphoblastic leukemia in adults: age distribution, BCR breakpoint and prognostic significance
journal contribution
posted on 1991-03-01, 00:00 authored by L M Secker-Walker, Jeffrey CraigJeffrey Craig, J M Hawkins, A V HoffbrandClonal karyotype, clinical and blast cell features were established in 113 adults, aged 15-68 (mean 31.2) years with acute lymphoblastic leukemia (ALL). The karyotypes were: Philadelphia positive (Ph+), 23 cases; t(4;11), six cases; other chromosome findings (group II), 84 cases. Ph+ patients were older (mean 39.7 years) at presentation than the group II patients (mean 28.3 years) (p less than 0.0001). Ph+ was less frequent than expected in teenagers (15-20 years) (10.3%) and patients aged 21-50 years (21.8%), and more frequent in patients over 50 years old (43.8%) (p less than 0.01). Follow-up (between 0.5 and 4.5 years) was obtained for 108 patients. Age and karyotype (Ph+ versus group II) were prognostically significant for event-free (EFS) and overall survival (S) (p less than 0.001 in each instance). Ph+ patients fared worse than group II cases in all age groups, but karyotype added prognostic significance to age only when Ph+ and t(4;11) cases were combined (group I) (group I versus group II: EFS, p = 0.054; S, p = 0.043). The Ph breakpoint location M-bcr+ (nine cases) and M-bcr- (14 cases) was irrelevant to age (mean 37.7 and 41.3, respectively) and to prognosis. The findings indicate a fundamental difference between the genetics of ALL in most older and the majority of younger patients which may partly explain the increasingly poor prognosis with age.
History
Journal
LeukemiaVolume
5Issue
3Pagination
196 - 199Publisher
Nature Publishing GroupLocation
London, Eng.ISSN
0887-6924Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
1991, Nature Publishing GroupUsage metrics
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AdolescentAdultAge FactorsAgedChromosome AberrationsFemaleFollow-Up StudiesHumansImmunophenotypingIncidenceLeukocyte CountMaleMiddle AgedPhiladelphia ChromosomePrecursor Cell Lymphoblastic Leukemia-LymphomaPrognosisTranslocation, GeneticScience & TechnologyLife Sciences & BiomedicineOncologyHematologyCHROMOSOMEFEATURESCHILDREN
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