Journal
LEUKEMIA
Volume 26, Issue 7, Pages 1507-1516Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/leu.2012.23
Keywords
acute lymphoblastic leukemia; prognosis; CRLF2; IKZF1
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Funding
- Ministry of Science and Technology [2008ZX09312-026, 2009ZX09103-431]
- National Basic Research Program (973) [2010CB529200]
- National Natural Science Foundation of China [30871106, 30772744, 30821063]
- Science and Technology Commission Foundation of Shanghai [09dZ1974500]
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The molecular characterization of cytogenetic abnormalities has not only provided insights into the mechanisms of leukemogenesis but also led to the establishment of new treatment strategies targeting these abnormalities and thereby further improve the prognosis of patients. We analyzed the prognosis of 1091 Chinese patients with newly diagnosed acute lymphoblastic leukemia (ALL) and explored the prognostic impacts of a large number of cytogenetic/molecular abnormalities. It was demonstrated that, in both B- and T-ALL settings, the prognosis was negatively correlated to the age as reported to date. For childhood T-ALL patients, it was also documented that the HOX11 expression represented a favorable prognostic factor as it was in adult ones. We identified CRLF2 overexpression as an intermediate-risk marker and Ik6 variant of IKZF1 gene as a high-risk one when stratifying pediatric B- ALL cases according to cytogenetic/molecular risks. We also found that Ik6 variant and CRLF2 overexpression had an important role in dictating the prognosis of Ph-negative patients, which may be useful markers in guiding the treatment of ALL in the future, with tyrosine kinase inhibitors on the other hand reversing the fate of Ph-positive ALL patients.
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