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Blood, 10 December 2009, Vol. 114, No. 25, pp. 5136-5145. Prepublished online as a Blood First Edition Paper on October 14, 2009; DOI 10.1182/blood-2009-08-231217. This Article Full Text (PDF) Supplemental Methods All Versions of this Article: blood-2009-08-231217v1 114/25/5136    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Marks, D. I. Articles by Lazarus, H. M. PubMed PubMed Citation Articles by Marks, D. I. Articles by Lazarus, H. M. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 4, 2009; accepted September 21, 2009. T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics and outcome from the large randomised prospective trial (UKALL XII/ECOG 2993) David I. Marks1,13, Elisabeth M. Paietta2, Anthony V. Moorman3, Susan M. Richards4, Georgina Buck4, Gordon DeWald5, Adolfo Ferrando6, Adele K. Fielding7, Anthony H Goldstone7, Rhett P. Ketterling5, Mark R. Litzow5, Selina M. Luger8, Andrew K. McMillan9, Marc Mansour7, Jacob M. Rowe10, Martin S. Tallman11 and Hillard M. Lazarus12 1 University Hospitals Bristol NHS Foundation Trust, United Kingdom; 2 Montefiore Medical Center, United States; 3 Newcastle University, United Kingdom; 4 CTSU, United Kingdom; 5 Mayo Clinic, United Kingdom; 6 Columbia University, United States; 7 University College London, United States; 8 University of Pennsylvania, United Kingdom; 9 Nottingham City Hospital, United Kingdom; 10 Rambam Medical Center, United States; 11 Northwestern University, United States; 12 Case Western University, United States * Corresponding author; email: david.marks{at}ubht.nhs.uk Abstract The biology and outcome of adult T-cell acute lymphoblastic leukemia are poorly understood. We present here the clinical and biological features of 356 patients treated uniformly on the prospective trial (UKALL XII/ECOG 2993) with the aim of describing the outcome and identifying prognostic factors. Complete remission was obtained in 94% of patients and 48% survived 5 years. Positivity of blasts for CD1a and lack of expression of CD13 were associated with better survival (p=0.01 and 0.0005 respectively). NOTCH1 and CDKN2A mutations were seen in 61% and 42% of those tested. Complex cytogenetic abnormalities were associated with poorer survival (19% vs 51% at 5 years, p=0.006). Central nervous system involvement at diagnosis did not affect survival (47% vs 48%, p=NS). For 99 patients randomised between autograft and chemotherapy 5 year survival was 51% in each arm. Patients with a matched sibling donor had superior 5 year survival to those without donors (61% vs 46%, chi-square p=0.02); this was due to less relapse (25% vs 51% at 5 years, p<0.001). Only 8 of 123 relapsed patients survive. This study provides a baseline for trials of new drugs such as nelarabine and may allow risk-adapted therapy in patients with poor-prognosis T-cell ALL. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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