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Hypodiploidy is associated with a poor prognosis in childhood acute
lymphoblastic leukemia
CH Pui, DL Williams, SC Raimondi, GK Rivera, AT Look, RK Dodge, SL George, FG Behm, WM Crist and SB Murphy
Leukemic cells from 31 (7.6%) of 409 children with newly diagnosed acute
lymphoblastic leukemia (ALL) had a hypodiploid karyotype. The patients'
ages ranged from 0.8 to 17 years (median, 5 years) and their initial
leukocyte counts from 1.0 to 132 X 10(9)/L (median, 12.7 X 10(9)/L). Modal
chromosome numbers for the leukemic stem lines were 45 in 26 cases, 28 in
two cases, and 26, 36 and 43 in one case each. Seven cases had one to three
additional abnormal lines due to clonal evolution. Chromosome 20 was lost
most frequently (nine cases). Structural abnormalities--including
chromosomal translocations (21 cases), deletions (ten cases), duplications
(two cases), or inversions (one case)--were common findings; the nonrandom
translocations consisted of the t(1;19)(q23;p13.3) in two pre-B cases and
tdic(9;12)(p1?1;p1?2) in three cases of common ALL. When compared with
hyperdiploid cases (greater than 50 chromosomes), ALL with hypodiploidy was
found to have a poorer outcome and was more likely to be associated with
chromosomal translocations, higher serum lactic dehydrogenase levels, and
age less than 2 or greater than or equal to 10 years. Moreover, patients
with hypodiploid ALL fared as poorly as those with pseudodiploid
karyotypes, even though their leukocyte counts and serum lactic
dehydrogenase levels were lower and they had a comparable frequency of
leukemic cell translocations. Hypodiploidy is therefore an unfavorable
karyotypic feature in childhood ALL.
Volume 70,
Issue 1,
pp. 247-253,
07/01/1987
Copyright © 1987 by The American Society of Hematology
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