Case-Control Study Suggests a Favorable Impact of TEL Rearrangement in Patients With B-Lineage Acute Lymphoblastic Leukemia Treated With Antimetabolite-Based Therapy: A Pediatric Oncology Group Study
| Autor: | D. Jeanette Pullen, Jeffrey E. Rubnitz, Michael P. Link, Vita J. Land, Jonathan J. Shuster, Ching-Hon Pui, Bruce M. Camitta, James R. Downing, Frederick G. Behm |
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| Rok vydání: | 1997 |
| Předmět: |
Oncology
Chemotherapy medicine.medical_specialty business.industry medicine.drug_class medicine.medical_treatment Immunology Case-control study Retrospective cohort study Cell Biology Hematology Gene rearrangement medicine.disease Biochemistry Antimetabolite Germline El Niño hemic and lymphatic diseases Acute lymphocytic leukemia Internal medicine Medicine business |
| Zdroj: | Blood. 89:1143-1146 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | TEL gene rearrangement is the most common genetic lesion in pediatric acute lymphoblastic leukemia (ALL), occurring in about 25% of B-lineage cases. We previously showed that, among patients treated on St Jude protocols, TEL rearrangement independently conferred an excellent prognosis. To extend these results to patients treated with antimetabolite-based therapy, we performed Southern blot analysis to determine the TEL gene status of 104 cases of B-lineage ALL treated on Pediatric Oncology Group 8602, matched on age, gender, and leukocyte count. There were 52 failures among the 77 patients with germline TEL, compared with only 8 failures among 27 patients in the rearranged group. Based on a two-sided logistic regression analysis, stratified for age (subdivided at 10 years), leukocyte count (subdivided at 50,000), and gender, the estimated odds of failing by 4 years in the germline TEL group is 5.4 times that of the rearranged TEL group, with 95% confidence from 1.9 to 15.6, two-sided P = .0009. Thus, the presence of a rearranged TEL gene is also associated with an improved survival among patients treated with antimetabolite-based therapy. Our results indicate that all newly diagnosed ALL patients should be screened for TEL gene rearrangements and suggest that these patients are candidates for less intensive therapy. |
| Databáze: | OpenAIRE |
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