Expression of TEL-AML1 fusion transcripts and response to induction therapy in standard risk acute lymphoblastic leukemia

F. M. Uckun*, N. Pallisgaard, P. Hokland, C. Navara, R. Narla, P. S. Gaynon, H. Sather, N. Heerema

*Corresponding author

Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

Abstract

We prospectively examined the frequency of the t(12;21)TEL-AML1 fusion in 504 children with newly diagnosed standard risk ALL using RT-PCR assays. Cells from 95 patients (18.8%) were TEL-AML1+. There was a significantly higher frequency of pseudodiploidy among the TEL-AML1+ cases (39.4% versus 14.1%, P=0.001), primarily because structural abnormalities involving 12p and del(6q) occurred more frequently in the TEL-AML1+ group. TEL-AML1+ ALL was more sensitive to the induction chemotherapy than TEL-AML1- ALL. The percentage of "rapid early responders", i.e., patients who achieved an M1 (<5% blasts) or M2 (5-25% blasts) marrow status on day 7 of induction chemotherapy, was significantly higher among TEL-AML1+ cases. The quality of remission of RT-PCR positive cases was excellent, as evidenced by the very low to absent MRD burden of their end-of-induction bone marrow specimens. TEL-AML1+ patients also had an excellent early EFS outcome. The probability of EFS at 30 months from study entry were 98.9±1.0% for the TEL-AML1+ group and 92.1 ± 1.5% for the TEL-AML1- group (P=0.0001). This prospective study significantly expands the knowledge gained from previous studies regarding the prognostic significance of t(12;21)TEL-AML1 fusion in pediatric ALL.

OriginalsprogEngelsk
TidsskriftLeukemia and Lymphoma
Vol/bind42
Udgave nummer1-2
Sider (fra-til)41-56
Antal sider16
ISSN1042-8194
DOI
StatusUdgivet - 2001
Udgivet eksterntJa

Emneord

  • ALL
  • Minimal residual disease
  • MRD
  • Rapid early response
  • Remission
  • TEL-AML1

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