Proposal and clinical application of molecular genetic risk scoring system, 'MRplus', for BCR-ABL1 negative pediatric B-cell acute lymphoblastic leukemia- report from a single centre
| Autor: | Ritu Gupta, Sameer Bakhshi, Ranjit Kumar Sahoo, Preity Sharma, Deepam Pushpam, Atul Sharma, Sanjeev Gupta, Vineet Kumar Kamal |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Scoring system Adolescent Childhood leukemia Fusion Proteins bcr-abl India BCR/ABL1 Negative Risk Factors CDKN2A Precursor B-Cell Lymphoblastic Leukemia-Lymphoma Internal medicine Molecular genetics Biomarkers Tumor medicine Humans Genetic risk Child Retrospective Studies business.industry Infant Hematology B-cell acute lymphoblastic leukemia Prognosis medicine.disease Single centre Oncology Child Preschool Mutation Female business Gene Deletion Follow-Up Studies |
| Zdroj: | Leukemia Research. 111:106683 |
| ISSN: | 0145-2126 |
| Popis: | We propose "MRplus", a molecular genetic risk score and check its clinical application in the risk-stratification of pediatric B-ALL.The genomic DNA of untreated pediatricBCR-ABL1 negative B-ALL patients was analyzed for deletions of IKZF1, PAX5, CDKN2A/B, BTG1, RB1, ETV6, EBF1, ERG, pseudoautosomal region(PAR) genes using multiplex ligation-dependent probe amplification, along with the routine genetic work-up. The patients were assigned an 'M'score- 0 (M0) for low and 1 (M1) for high genetic-risk as per the criteria by Moorman et al., and another score "IKplus"-1 (IKplus1) for IKZF1plus as per the criteria by Stanulla et al., and 0 (IKplus0) for other patients. The final "MRplus" risk-score of 0 (MRplus0), 1 (MRplus1) or 2 (MRplus2) was obtained by adding both these scores. The association of risk scores with overall survival (OS) and event free survival(EFS) was seen using Cox proportion hazard model. The overall goodness of fit of the model was done using Cox-Snell residuals.The median age of 320 patients was 6 years (1-18 years). The patients with score M1 were 139 (43.4 %), M0-181 (56.6 %); IKplus1-32 (10 %) and IKplus0-288 (90 %). The final "MRplus" score of 0,1,or 2 was obtained in 181(56.6 %), 107(33.4 %) and 32(10 %) patients respectively. The post-induction remission rate was 90.7 %, 77.8 %, 73.9 % (p = 0.004); 4-year OS 67 %, 48 %, 27 % (p0.001); and 4-year EFS 56 %, 34 %, 19 %(p0.001) in patients with "MRplus" score 0,1,and 2 respectively.The proposed "MRplus" scoring at baseline could identify three distinct risk groups-good (MRplus0), intermediate (MRplus1) and poor (MRplus2), with different outcomes; in pediatricBCR-ABL1 negative B-ALL. This may help in better risk-stratification and selection of patients for alternative treatment approaches. |
| Databáze: | OpenAIRE |
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