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The aim of our study was to analyze the factors contributing to heterogeneity of prognosis in patients with hyperdiploidy>50 chromosomes (HD>50), a group of B-cell precursor acute lymphoblastic leukemia with favorable outcome. The 541 HD>50 patients registered prospectively in the 58951 European Organisation for Research and Treatment of Cancer (EORTC) Children's Leukemia Group (CLG) trial, identified by karyotype (446 patients) and by DNA index (DI) (490 patients), had a 6-year event-free survival (EFS) of 89.0% (standard error [SE] = 1.5%) and a 6-year overall survival (OS) of 95.9% (SE = 0.9%). The strongest prognostic factor was the modal number of chromosomes (MNC): the 6-year EFS of 51-53, 54-57, and 58-66 MNC groups were 80%, 89%, and 99%, respectively (P < .0001). Ploidy assessed by DI was also a favorable factor: the higher the DI, the better the outcome. The 6-year EFS of the 3 subgroups of DI < 1.16/≥1.16-<1.24/≥1.24 were 83%, 90%, and 95%, respectively (P = .009). All usual combinations of trisomies (chromosomes 4, 10, 17, 18) were significant favorable factors but had lower EFS when MNC was lower than 58. In multivariate analysis, MNC remained the strongest factor. Consequently, the best indicator for excellent outcome was ploidy assessed by karyotype because patients with 58-66 chromosomes stood every chance of being cured (OS of 100% at 6-year follow-up) with less-intensive therapy. This trial was registered at www.clinicaltrials.gov as #NCT00003728. Registered: http://www.eortc.org/, http://clinicaltrials.gov/show/NCT00003728.
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http://dx.doi.org/10.1182/blood-2012-06-437681 | DOI Listing |
Infect Drug Resist
December 2024
Department of Clinical Laboratory, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
Background: is one of the major pathogens in mucormycosis. Infection due to is rare and has a high mortality rate, especially disseminated mucormycosis infections. Rapid and accurate pathogen identification is important for the development of targeted antifungal therapies.
View Article and Find Full Text PDFFront Pediatr
December 2024
Department of Hematology and Oncology, Dalian Women and Children's Medical Group, Dalian, China.
Leukapheresis is a treatment used to reduce leukocytes to decrease the number of white blood cells in circulation and prevent the risks of hyperviscosity and cerebrovascular and pulmonary leukostasis. We present a case of pro-B-cell acute lymphoblastic leukemia (ALL) with hyperleukocytosis in a 6-month-old infant, characterized by a positive KMT2A/AFF1 fusion gene with a leukocyte count of 1,755 × 10/L. After two consecutive sessions of leukapheresis, the white blood cell count decreased to 55 × 10/L.
View Article and Find Full Text PDFiScience
December 2024
Department of Hematology, Affiliated Hospital of Shandong Second Medical University, Weifang 261000, China.
Children are the main susceptible group to acute lymphoblastic leukemia (ALL), and the lack of sufficient data has impeded a comprehensive understanding of its global impact. This study analyzed the annual numbers and rates of incidence, deaths, and disability-adjusted life years (DALYs) of childhood ALL from 1990 to 2021, disaggregated by age group, gender, and socio-demographic index (SDI) at the global, regional, and national levels, based on the 2021 Global Burden of Disease (GBD) database. Although global deaths and DALYs rates for childhood ALL showed declining trends, the incidence rate fluctuated.
View Article and Find Full Text PDFHematol Oncol
January 2025
Hematology, Oncology R&D, AstraZeneca, Cambridge, UK.
Contemporary studies of Bruton tyrosine kinase inhibitor (BTKi) resistance focus on mutations in the B-cell receptor (BCR) pathway, but alternative mechanisms of resistance remain undefined. Here, we sought to identify novel predictive markers of acquired resistance to acalabrutinib, a second-generation BTKi, in patients with chronic lymphocytic leukemia (CLL). Clinical samples from 41 patients with relapsed/refractory or treatment-naive CLL receiving acalabrutinib as part of a clinical trial (NCT02029443) were divided into two groups: those who continued to respond to treatment (NP, n = 23) and those who developed progressive disease on acalabrutinib therapy (PD, n = 18).
View Article and Find Full Text PDFJ Yeungnam Med Sci
December 2024
Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Malaysia.
Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse.
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