Leukemia in infants prognosticated by MLL/11q23 rearrangement, CD10 expression, and age

09-28-2006

Acute lymphoblastic leukemia (ALL) in infants could be prognosticated by MLL/11q23 rearrangement, CD10 expression, and age, but not molecular 11q23 translocation partners.

According to recent research from the United States, "Infant ALL has a poor therapeutic outcome despite attempts to treat it based on prognostic factor-guided therapy. This is the first cooperative group trial characterizing all infants at the molecular level for MLL/11q23 rearrangement."

"All infants enrolled on Children's Cancer Group (CCG) 1953 were tested for MLL rearrangement by Southern blot and the 11q23 translocation partner was identified (4;11, 9;11, 11;19, or 'other') by reverse-transcriptase polymerase chain reaction (PCR)," explained J.M. Hilden and colleagues, Cleveland Clinic. "One hundred fifteen infants were enrolled; overall event-free survival (EFS) was 41.7% (SD=9.2%) and overall survival (OS) was 44.8% at 5 years. Five-year EFS for MLL-rearranged cases was 33.6% and for MLL-nonrearranged cases was 60.3%.

"The difference in EFS between the 3 major MLL rearrangements did not reach statistical significance. Multivariate Cox regression analyses showed a rank order of significance for negative impact on prognosis of CD10 negativity, age younger than 6 months, and MLL rearrangement, in that order. Toxicity was the most frequent cause of death. Relapse as a first event in CCG 1953 was later (median, 295 days) compared with CCG 1883 historic control (median, 207 days)."

The researchers concluded, "MLL/11q23 rearrangement, CD10 expression, and age are important prognostic factors in infant ALL, but molecular 11q23 translocation partners do not predict outcome."

Hilden and colleagues published their study in Blood (Analysis of prognostic factors of acute lymphoblastic leukemia in infants: report on CCG 1953 from the Children's Oncology Group. Blood, 2006;108(2):441-451).

For additional information, contact J.M. Hilden, Cleveland Clinic, Columbus Children's Hospital, 9500 Euclid Avenue, Desk S20, Cleveland, OH 44195, USA.

Publisher contact information for the journal Blood is: American Society Hematology, 1900 M Street. NW Suite 200, Washington, DC 20036, USA.

Keywords: Cleveland, Ohio, United States, Diagnosis, Diagnostics, Oncology, Pediatric, Prognosis, Prognostics, Proteins, Proteomics, Acute Lymphoblastic Leukemia, Infants, MLL/11q23 Rearrangement, CD10 Expression, Age, Molecular 11q23 Translocation Partners, Outcome.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.