Clinical Outcome of the Chromosomal Abnormalities in Adult Acute Lymphoblastic Leukemia (Preliminary Data)

Kim, Hyo Jin; Kwon, Hyuk Chan; Lee, Kee Hyun; Kim, Jae Seok; Han, Jin Yeong

Abstract

BACKGROUND: Adult acute lymphoblastic leukemia (ALL) is a hematologic malignant disease characterized by an uncontrolled proliferation of immature lymphocytes and their progenitors. Because specific chromosomal abnormalities are associated with ALL, cytogenetic studies can help classifying the disease, providing the clues of disease, progression and being used to monitor remission after chemotherapy. So, we have performed cytogenetic studies to identify the incidence of chromosomal abnormalities and their prognostic significance in patients with ALL.
METHODS
From August 1996 to July 1999, we evaluated chromosomal abnormalities in 25 patients with acute lymphoblastic leukemia by high resolution banding technique. Among them, 22 patients were treated with vincristine, prednisone, daunorubicin, L-asparagenase (VPDL) to induce complete remission. We divided patients who had hyperdiploidy, normal karyotype into good risk group (A), and t(9;22), undetermined prognostic karyotype group into poor risk group (B).
RESULTS
The incidence of chromosomal ab-normalities was 50% (11/22). The median follow up duration of 22 evaluable patients was 11.1 months. The complete remission (CR) rate was 82% (18/22). The CR rate in group A and B were 100% (14/14), 50% (4/8) respectively (P=0.01). The median remission duration was 30.1 months. The median remission duration of group B was 7.3 months, and that of group A was 30.1 months (P=0.0188). Overall median survival duration was 13.7 months, and the median survival duration in A and B group was 32.5 months and 3.5 months respectively (P= 0.0261).
CONCLUSION
The incidence of chromosomal abnormalities in patients with acute lymphoblastic leukemia were relatively high and chromosomal abnormalities were one of useful prognostic factors in remission duration and survival duration. Tailored therapy according to chromosomal abnormalities is desired for more effective results.