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Poor prognosis of children with pre-B acute lymphoblastic leukemia is
associated with the t(1;19)(q23;p13): a Pediatric Oncology Group study
WM Crist, AJ Carroll, JJ Shuster, FG Behm, M Whitehead, TJ Vietti, AT Look, D Mahoney, A Ragab and DJ Pullen
St Jude Children's Research Hospital.
The prognostic significance of chromosomal translocations, particularly
t(1;19) (q23;p13), was evaluated in children with pre-B and early pre-B
acute lymphoblastic leukemia (ALL). Patients were treated on a risk- based
protocol of the Pediatric Oncology Group (POG) between February 1986 and
May 1989. An abnormal clone was detected in 46% (130 of 285) of pre-B cases
and 56% (380 of 679) of early pre-B cases. Translocation of any type was
associated with a worse treatment outcome than other karyotypic
abnormalities: 15 of 66 versus 3 of 64 failed therapy in the pre-B group (P
= .001), and 37 of 141 versus 23 of 239 failed in the early pre-B group (P
less than .001). The t(1;19) (q23;p13) occurred significantly more often in
cases of pre-B ALL with a clonal abnormality than in early pre-B ALL cases
(29 of 130 v 5 of 380, P less than .001). Among the 285 pre-B cases in
which bone marrow was studied cytogenetically, those with t(1;19) had a
significantly worse treatment outcome than all others (11 of 29 v 27 of 256
have failed therapy, P less than .001). This difference is significant (P
less than .001) after adjustment for leukocyte count, age, and other
relevant features. Cases with the t(1;19) also had a worse prognosis than
pre-B patients with other translocations (4 of 37 have failed, P less than
.01) or with any other karyotypic abnormality (7 of 101 have failed, P less
than .001). We conclude that chromosomal translocations confer a worse
prognosis for non-T, non-B-cell childhood ALL, and that the t(1;19) is
largely responsible for the poor prognosis of the pre-B subgroup.
Volume 76,
Issue 1,
pp. 117-122,
07/01/1990
Copyright © 1990 by The American Society of Hematology
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