Study of Cytogenetic Alterations and Association With Prognostic Factors in Indian Children With B-Lineage Acute Lymphoblastic Leukemia.

BACKGROUND

Acute lymphoblastic leukemia (ALL) is a heterogeneous disorder with coexistence of multiple clones. The mortality rate in children with ALL has reduced to 15% to 20% in developed countries. However, it continues to be high in India (25%-35%), which may be attributed to ethnic variation and differences in disease biology. The treatment and outcome in ALL are dependent on risk stratification, which is derived from prognostic factors like leukocyte count, age at diagnosis, immunophenotypic subtypes and, most importantly, cytogenetic alterations. Chromosomal rearrangements are important initiating events in leukemogenesis. Approximately, 75% of children with ALL harbor a recurring chromosomal alteration detectable by karyotyping, fluorescence in situ hybridization, or other molecular techniques. The present study was planned to compare the prevalence of various cytogenetic alterations with western. literature and to see the association of these cytogenetic alterations with other prognostic factors as well as survival outcome.

METHODS

We enrolled, 117 children of 1 to 14 years of age with newly diagnosed B-cell ALL from August 2014 to Mar 2016 prospectively. Patients were monitored for response to prednisolone, postinduction complete morphological remission minimal residual disease assessment, and were followed for a minimum 2 years.

RESULTS AND DISCUSSION: We observed that poor-risk cytogenetic alterations were more prevalent, whereas good-risk cytogenetic alterations were less frequent in our patient cohort as compared with western studies.

CONCLUSIONS

We observed that event-free survival is significantly less in those with poor-risk cytogenetics. We have also highlighted nonrecurrent alterations observed in our study group.