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Blood, 15 March 2007, Vol. 109, No. 6, pp. 2327-2330.
Prepublished online as a Blood First Edition Paper on November 9, 2006; DOI 10.1182/blood-2006-08-040436.
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Submitted August 8, 2006
Accepted October 28, 2006
Prognosis of children with acute lymphoblastic leukaemia (ALL) and intrachromosomal amplification of chromosome 21 (iAMP21)
Anthony V Moorman*, Susan M Richards, Hazel M Robinson, Jon C Strefford, Brenda E S Gibson, Sally E Kinsey, Tim O B Eden, Ajay J Vora, Christopher D Mitchell, and Christine J Harrison
Leukaemia Research Cytogenetics Group, Cancer Sciences Division, University of Southampton, Southampton, United Kingdom
Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom
Department of Haematology, Yorkhill NHS Trust, Glasgow, United Kingdom
Department of Haematology, St James Hospital, Leeds, United Kingdom
Academic Unit of Paediatric and Adolescent Oncology, Christie Hospital and Central Manchester Children's University Hospitals Trusts, Manchester, United Kingdom
Department of Haematology, Sheffield Children's Hospital, Sheffield, United Kingdom
John Radcliffe Hospital, Oxford, United Kingdom
* Corresponding author; email: avm{at}soton.ac.uk.
Patients with acute lymphoblastic leukaemia (ALL) and an intrachromosomal amplification of chromosome 21 (iAMP21) comprise a novel and distinct biological subgroup. We prospectively screened 1,630 (84%) patients treated on the UK MRC ALL97 protocol for iAMP21 and herein present demographic, clinical and survival data on the 28 (2%) children found to harbour this abnormality. They had a common or pre-B ALL immunophenotype, were significantly older (median 9 versus 5 years) and had a lower white cell count (median 3.9 versus 12.4) compared to children without this abnormality. Notably, iAMP21 patients had a significantly inferior event free and overall survival at 5 years compared with other patients: 29% (95% CI 13%-48%) versus 78% (76%-80%) and 71% (51%-84%) versus 87% (85%-88%), respectively. As a result of this three-fold increase in relapse risk, newly diagnosed iAMP21 patients recruited to the current UK MRC ALL2003 trial are being treated on the high risk arm and are considered for bone marrow transplant in first remission.
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