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Clinical characteristics and treatment outcome of childhood acute
lymphoblastic leukemia with the t(4;11)(q21;q23): a collaborative study of
40 cases [see comments]
CH Pui, LS Frankel, AJ Carroll, SC Raimondi, JJ Shuster, DR Head, WM Crist, VJ Land, DJ Pullen and CP Steuber
St Jude Children's Research Hospital, Memphis, TN 38101.
The t(4;11)(q21;q23) chromosomal abnormality was identified in 40 (2%) of
1,986 children with newly diagnosed acute lymphoblastic leukemia (ALL).
This translocation was associated with female sex (63%), age less than 1
year (60%), hyperleukocytosis (median leukocyte count, 156.5 x 10(9)/L),
CD10-/CD19+ B-precursor cell immunophenotype, and myeloid-associated
antigen (CD15) expression (63%). Nearly all cases had at least some CD24-
blast cells. The CD10-/CD15%/CD19+/CD24/+ phenotype was found in 20 of the
32 t(4;11) cases tested. None of the 40 cases had the cytogenetic finding
of hyperdiploidy greater than 50, which is a favorable prognostic feature.
For clinical comparison, the t(4;11) cases were divided into three groups
according to age at diagnosis: less than 1 year (n = 24), 1 to 9 years (n =
8), and greater than or equal to 10 years (n = 8). Compared with older
patients, infants were more likely to have initial central nervous system
leukemia (P = .05) and less likely to have pre-B-cell ALL (P = .05).
Complete continuous remission has been maintained in only 7 of 24 infants
and 2 of 8 patients aged greater than or equal to 10 years, in contrast to
7 of 8 children in the intermediate age group (P = .048). These findings
suggest that the t(4;11) is an adverse prognostic feature in these two age
groups.
Volume 77,
Issue 3,
pp. 440-447,
02/01/1991
Copyright © 1991 by The American Society of Hematology
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