Abstract

Among the well-described cytogenetic abnormalities in adults with acute lymphoblastic leukemia (ALL), a translocation involving chromosomes 1 and 19 [t(1;19) (q23;p13)] occurs in a small subset but has varyingly been associated with a good or bad prognosis in different studies.

Adults with ALL and t(1;19) treated at M.D. Anderson Cancer Center were reviewed. Their clinical features and outcome were compared to those with other cytogenetic abnormalities. Endpoints included complete remission rate (CR), complete response duration (CRD) and overall survival (OS).

Of 411 adults with pre-BALL, 12 patients had t(1;19). Ten of the 12 patients with t(1;19) received Hyper-CVAD (Cyclophosphamide, Vincristine, Adriamycin, Dexamethasone alternating with Methotrexate and high-dose Cytarabine); the other 2 were treated with VAD (Vincristine, Adriamycin, Dexamethasone). All 12 patients achieved CR; the 3-year survival rate was 73%. Patients with t(1;19) had significantly better CRD and OS when compared to all other patients combined as well as individually to patients with Ph+, t(4;11), and lymphoma-like abnormalities [6q(−), 14q+, t(11;14), t(14;18)].

Adults with ALL and t(1;19) have an excellent prognosis when treated with the Hyper-CVAD regimen.

Outcome of patients by cytogenetic group: t(1;19) vs. individual cytogenetic groups

OVERALL SURVIVAL Fail 3-Year % Median (weeks) P-value 
T(1,19) 12 73 Not recorded  
Diploid 138 72 52 179 0.09 
Lymphoma-like 20 17 35 54 0.008 
Ph+ 117 88 23 68 0.0002 
Miscellaneous 112 56 56 236 0.17 
T(4,11) 12 10 58 0.002 
COMPLETE RESPONSE DURATION (CRD) Fail 3-Year % Median (weeks) P-value 
T(1,19) 12 80 Not recorded  
Diploid 133 59 54 177 0.06 
Lymphoma-like 16 13 34 89 0.009 
Ph+ 102 52 42 63 0.006 
Miscellaneous 100 41 59 401 0.16 
T(4,11) 11 NR 45 0.018 
OVERALL SURVIVAL Fail 3-Year % Median (weeks) P-value 
T(1,19) 12 73 Not recorded  
Diploid 138 72 52 179 0.09 
Lymphoma-like 20 17 35 54 0.008 
Ph+ 117 88 23 68 0.0002 
Miscellaneous 112 56 56 236 0.17 
T(4,11) 12 10 58 0.002 
COMPLETE RESPONSE DURATION (CRD) Fail 3-Year % Median (weeks) P-value 
T(1,19) 12 80 Not recorded  
Diploid 133 59 54 177 0.06 
Lymphoma-like 16 13 34 89 0.009 
Ph+ 102 52 42 63 0.006 
Miscellaneous 100 41 59 401 0.16 
T(4,11) 11 NR 45 0.018 

Disclosures: Kantarjian:Novartis: Research Funding. Faderl:Genzyme: Honoraria, Research Funding. Ravandi:Genzyme: Honoraria, Research Funding. O’Brien:BMS: Research Funding.

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