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Blood, 15 January 2006, Vol. 107, No. 2, pp. 473-479.
Prepublished online as a Blood First Edition Paper on September 22, 2005; DOI 10.1182/blood-2005-04-1754.
 Previous Article | Next Article 
Submitted April 29, 2005
Accepted September 8, 2005
Adult T-cell acute lymphoblastic leukemia: biologic profile at presentation and correlation with response to induction treatment in patients enrolled in the GIMEMA LAL 0496 protocol
Antonella Vitale*, Anna Guarini, Cristina Ariola, Marco Mancini, Cristina Mecucci, Antonio Cuneo, Fabrizio Pane, Giuseppe Saglio, Giuseppe Cimino, Agostino Tafuri, Giovanna Meloni, Francesco Fabbiano, Anna Recchia, Maria Grazia Kropp, Mauro Krampera, Nicola Cascavilla, Felicetto Ferrara, Antonio Romano, Patrizio Mazza, Claudio Fozza, Francesca Paoloni, Marco Vignetti, and Robin Foa'
Department of Cellular Biotechnologies and Hematology, University, University La Sapienza, Roma, Italy
Hematology and Bone Marrow Transplantation Unit, University of Perugia, Perugia, Italy
Department of Biomedical Sciences and Advances Therapies, University of Ferrara, Ferrara, Italy
Department of Biochemistry and Medical Biotechnology, Federico II University, Federico II University, CEINGE Biotecnologie Avanzate, Napoli, Italy
Department of Clinical and Biological Sciences, University, S. Luigi Gonzaga Hospital, University of Torino, Orbassano, Torino, Italy
Hematology, Hospital Cervello, Palermo, Italy
Hematology, Civil Hospital, Pescara, Italy
Hematology, Azienda Ospedaliera A. Pugliese, Catanzaro, Italy
Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
Hematology, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Foggia, Italy
Hematology, Cardarelli Hospital, Napoli, Italy
Ospedale Regionale A. Di Summa, Brindisi, Italy
Ospedale S.S. Annunziata, Taranto, Italy
Univeristy of Sassari, Sassari, Italy
GIMEMA Data Center, Roma, Italy
Department of Cellular Biotechnologies and Hematology, University, University La Sapienza, Roma, Italy; GIMEMA Data Center, Roma, Italy
* Corresponding author; email: vitale{at}bce.uniroma1.it.
Between 1996 and 2000, 90 newly diagnosed adult T-acute lymphoblastic leukemia (T-ALL) patients were registered in the GIMEMA 0496 protocol. Cases were centrally processed for morphology, immunophenotype, cytogenetics, molecular biology and multidrug resistance (MDR). Twenty-two were females and 68 males. Four % of cases were pro-T, 47% pre-T, 39% cortical T and 10% mature T-ALL. Fifty-six % of pro-T + pre-T-ALL patients achieved CR compared to 91% for cortical + mature cases (p=0.002). CD34 expression was associated with a significantly lower CR rate: 54% vs 84% (p=0.009). 31/85 patients (36.5%) had an abnormal karyotype, the most common abnormality (15%) being a partial del(6q). The cytogenetic profile did not impact on CR achievement. MDR1 function, present in 26% of cases, correlated significantly with CR achievement (p=0.004). A highly significant (p=0.001) difference in CR rate was observed between patients who did not express the CD13/CD33/CD34 antigens and were MDR functionally negative (96%) compared to patients positive for at least one of these markers (57%). Multivariate analysis showed an impact on CR achievement for CD33 expression and MDR1 function. An extensive biologic work-up of adult T-ALL cases at presentation is recommended in order to design tailored therapeutic strategies aimed at improving CR rates.
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