1. Clinico-biologic features of 5202 acute lymphoblastic leukemia patients enrolled in the Italian AIEOP and GIMEMA Protocols and stratified in age-cohorts
- Author
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Chiaretti, S, Vitale, A, CAZZANIGA, GIOVANNI ITALO, Orlando, S, Silvestri, D, Fazi, P, VALSECCHI, MARIA GRAZIA, Elia, L, Testi, A, MANCINI, FLAVIA, Conter, V, Te Kronnie, G, Ferrara, F, Di Raimondo, F, Tedeschi, A, Fioritoni, G, Fabbiano, F, Meloni, G, Specchia, G, Pizzolo, G, MANDELLI, FABIO, Guarini, A, Basso, G, BIONDI, ANDREA, Foa', R., Chiaretti, S, Vitale, A, Cazzaniga, G, Orlando, S, Silvestri, D, Fazi, P, Valsecchi, M, Elia, L, Testi, A, Mancini, F, Conter, V, Te Kronnie, G, Ferrara, F, Di Raimondo, F, Tedeschi, A, Fioritoni, G, Fabbiano, F, Meloni, G, Specchia, G, Pizzolo, G, Mandelli, F, Guarini, A, Basso, G, Biondi, A, and Foa', R
- Subjects
Adult Acute Lymphoblastic Leukemia ,Cytogenetics and Molecular Genetics ,Immunophenotyping ,Pediatric Acute Lymphoblastic Leukemia - Abstract
Acute lymphoblastic leukemia shows marked differences in outcome between children and adults. Since there is limited information on the distribution of clinico-biologic variables in different age cohorts, we analyzed 5202 ALL patients enrolled in the Italian multicenter AIEOP and GIMEMA protocols and stratified them in 9 age cohorts. The highest prevalence of ALL was observed in children, although a second peak was recorded from the 4th decade onwards. Interestingly, the lowest incidence was found in females between 14-40 years, suggesting a protective impact of fertility. Immunophenotypic characterization showed a B-lineage in 85.8% of patients: a pro-B stage, associated to MLL/AF4 positivity, was more frequent in patients between 10-50 years. A T-lineage (14.2%) was rare among small children and increased in 10-40 years patients. The BCR/ABL1 rearrangement increased progressively with age, starting from the 10-14 cohort and impacting for 52.7% of cases in the 6th decade. Similarly, the MLL/AF4 rearrangement constantly increased up to the 5th decade, while the ETV6/RUNX1 rearrangement disappeared from the age of 30 onwards. This study shows that adolescents and young adults are characterized by a male prevalence, greater T-lineage acute lymphoblastic leuekmia percentage, an increase of poor prognostic molecular markers with aging compared to children, and conclusively quantifies the progressive increase with age of BCR/ABL+ patients, potentially manageable by targeted therapies.
- Published
- 2013