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Blood, 15 April 2007, Vol. 109, No. 8, pp. 3189-3197. Prepublished online as a Blood First Edition Paper on December 14, 2006; DOI 10.1182/blood-2006-10-051912. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-10-051912v1 109/8/3189    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map 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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Moorman, A. V. Articles by Dewald, G. W. Search for Related Content PubMed PubMed Citation Articles by Moorman, A. V. Articles by Dewald, G. W. Related Collections Neoplasia Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS CLINICAL TRIALS AND OBSERVATIONS Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial Anthony V. Moorman1, Christine J. Harrison1, Georgina A. N. Buck2, Sue M. Richards2, Lorna M. Secker-Walker1, Mary Martineau1, Gail H. Vance3, Athena M. Cherry4, Rodney R. Higgins5, Adele K. Fielding6, Letizia Foroni6, Elisabeth Paietta7, Martin S. Tallman8, Mark R. Litzow9, Peter H. Wiernik7, Jacob M. Rowe10, Anthony H. Goldstone11, Gordon W. Dewald, on behalf of the Medical Research Council (MRC)/National Cancer Research Institute (NCRI) Adult Leukaemia Working Party of the United Kingdom and the Eastern Cooperative Oncology Group12 1 Leukaemia Research Cytogenetics Group, Cancer Sciences Division, University of Southampton, United Kingdom; 2 Clinical Trial Service Unit, University of Oxford, United Kingdom; 3 Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN; 4 Department of Pathology, Stanford University School of Medicine, Stanford, CA; 5 Allina Medical Laboratories, Abbott Northwestern Hospital, Minneapolis, MN; 6 Department of Haematology, Royal Free and University College Medical School (UCMS), London, United Kingdom; 7 Comprehensive Cancer Center, Our Lady of Mercy Medical Center, New York, NY; 8 Division of Hematology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; 9 Division of Hematology, Mayo Clinic, Rochester, MN; 10 Department of Hematology, Rambam Medical Center, Haifa, Israel; 11 Department of Haematology, University College London Hospital (UCLH), United Kingdom; 12 Division of Laboratory Genetics, Mayo Clinic, Rochester, MN Pretreatment cytogenetics is a known predictor of outcome in hematologic malignancies. However, its usefulness in adult acute lymphoblastic leukemia (ALL) is generally limited to the presence of the Philadelphia (Ph) chromosome because of the low incidence of other recurrent abnormalities. We present centrally reviewed cytogenetic data from 1522 adult patients enrolled on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. The incidence and clinical associations for more than 20 specific chromosomal abnormalities are presented. Patients with a Ph chromosome, t(4;11)(q21;q23), t(8;14)(q24.1;q32), complex karyotype (5 or more chromosomal abnormalities), or low hypodiploidy/near triploidy (Ho-Tr) all had inferior rates of event-free and overall survival when compared with other patients. In contrast, patients with high hyperdiploidy or a del(9p) had a significantly improved outcome. Multivariate analysis demonstrated that the prognostic relevance of t(8;14), complex karyotype, and Ho-Tr was independent of sex, age, white cell count, and T-cell status among Ph-negative patients. The observation that Ho-Tr and, for the first time, karyotype complexity confer an increased risk of treatment failure demonstrates that cytogenetic subgroups other than the Ph chromosome can and should be used to risk stratify adults with ALL in future trials. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Karyng about karyotyping in adult ALL Frederick R. Appelbaum Blood 2007 109: 3127. [Full Text] [PDF] This article has been cited by other articles: D. I. Marks, W. S. Perez, W. He, M.-J. Zhang, M. R. Bishop, B. J. Bolwell, C. N. Bredeson, E. A. Copelan, R. P. Gale, V. Gupta, et al. 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L. Slovak, K. J. Kopecky, S. J. Forman, and F. R. Appelbaum Impact of cytogenetics on the outcome of adult acute lymphoblastic leukemia: results of Southwest Oncology Group 9400 study Blood, March 1, 2008; 111(5): 2563 - 2572. [Abstract] [Full Text] [PDF] M. Yanada, J. Takeuchi, I. Sugiura, H. Akiyama, N. Usui, F. Yagasaki, K. Nishii, Y. Ueda, M. Takeuchi, S. Miyawaki, et al. Karyotype at diagnosis is the major prognostic factor predicting relapse-free survival for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib-combined chemotherapy Haematologica, February 1, 2008; 93(2): 287 - 290. [Abstract] [Full Text] [PDF] F. R. Appelbaum Indications for Hematopoietic Cell Transplantation for the Treatment of Adult Acute Leukemia ASCO Educational Book, January 1, 2008; 2008(1): 325 - 329. [Abstract] [Full Text] [PDF] V. Bedell, S. J. Forman, K. Gaal, V. Pullarkat, L. M. Weiss, and M. L. Slovak Successful Application of a Direct Detection Slide-Based Sequential Phenotype/Genotype Assay Using Archived Bone Marrow Smears and Paraffin Embedded Tissue Sections J. Mol. Diagn., November 1, 2007; 9(5): 589 - 597. [Abstract] [Full Text] [PDF] J. M. Rowe and A. H. Goldstone How I treat acute lymphocytic leukemia in adults Blood, October 1, 2007; 110(7): 2268 - 2275. [Abstract] [Full Text] [PDF] J. E. Karp, R. M. Ricklis, K. Balakrishnan, J. Briel, J. Greer, S. D. Gore, B. D. Smith, M. A. McDevitt, H. Carraway, M. J. Levis, et al. A phase 1 clinical-laboratory study of clofarabine followed by cyclophosphamide for adults with refractory acute leukemias Blood, September 15, 2007; 110(6): 1762 - 1769. [Abstract] [Full Text] [PDF] H. M. Lazarus and S. Luger Which Patients with Adult Acute Lymphoblastic Leukemia Should Undergo a Hematopoietic Stem Cell Transplantation? Case-Based Discussion Hematology, January 1, 2007; 2007(1): 444 - 452. [Abstract] [Full Text] [PDF]

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