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Blood, 1 June 2006, Vol. 107, No. 11, pp. 4508-4513.
Prepublished online as a Blood First Edition Paper on February 21, 2006; DOI 10.1182/blood-2005-08-3451.
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Submitted August 26, 2005
Accepted January 20, 2006
Prospective analysis of TEL/AML1 positive patients treated on Dana-Farber Cancer Institute Consortium Protocol 95-01
Mignon L Loh*, Meredith A Goldwasser, Lewis B Silverman, Wing-Man Poon, Shashaank Vattikuti, Angelo Cardoso, Donna S Neuberg, Kevin M Shannon, Stephen E Sallan, and D G Gilliland
Department of Pediatrics, University of California, San Francisco, CA, USA; Comprehensive Cancer Center, University of California, San Francisco, CA, USA
Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA; Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium, Boston, MA, USA
Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium, Boston, MA, USA; Children's Hospital, Boston, MA, USA
Department of Pediatrics, University of California, San Francisco, CA, USA
Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium, Boston, MA, USA
Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Howard Hughes Institute of Medicine, Boston, MA, USA
* Corresponding author; email: lohm{at}peds.ucsf.edu.
In a retrospective analysis, we previously reported that children whose leukemia cells harbored the TEL/AML1 gene rearrangement have an excellent outcome. From 1996-2000, we conducted a prospective study to determine the incidence and outcome of children with TEL/AML1 positive ALL. Newly diagnosed children with ALL were treated on DFCI ALL Consortium Protocol 95-01. Patients were risk stratified primarily by current NCI-Rome risk criteria. With a median follow-up of 5.2 years, the five-year event-free survival for TEL/AML1-positive patients was 89% compared with 80% for TEL/AML1-negative B-precursor patients (p=0.05). Five-year overall survival was 97% among TEL/AML1-positive patients versus 89% among TEL/AML1-negative patients (p=0.03). However, in a multivariable analysis, risk group (age and leukocyte count at diagnosis) and asparaginase treatment group, but not TEL/AML1 status, were found to be independent predictors of outcome. We conclude that TEL/AML1-positive patients have an excellent outcome, confirming our previous findings. However, factors such as age at diagnosis and presenting leukocyte count should be taken into consideration when treating this group of patients.

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