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Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts.

Abstract

The outcome of children and adults with acute lymphoblastic leukemia is markedly different. Since there is limited information on the distribution of clinico-biological variables in different age cohorts, we analyzed 5202 patients with acute lymphoblastic leukemia enrolled in the Italian multicenter AIEOP and GIMEMA protocols and stratified them in nine age cohorts. The highest prevalence of acute lymphoblastic leukemia was observed in children, although a second peak was recorded from the 4(th) decade onwards. Interestingly, the lowest incidence was found in females between 14-40 years. Immunophenotypic characterization showed a B-lineage in 85.8% of patients: a pro-B stage, associated with MLL/AF4 positivity, was more frequent in patients between 10-50 years. T-lineage leukemia (14.2%) was rare among small children and increased in patients aged 10-40 years. The prevalence of the BCR/ABL1 rearrangement increased progressively with age starting from the cohort of patients 10-14 years old and was present in 52.7% of cases in the 6th decade. Similarly, the MLL/AF4 rearrangement constantly increased up to the 5(th) decade, while the ETV6/RUNX1 rearrangement disappeared from the age of 30 onwards. This study shows that acute lymphoblastic leukemia in adolescents and young adults is characterized by a male prevalence, higher percentage of T-lineage cases, an increase of poor prognostic molecular markers with aging compared to cases in children, and conclusively quantified the progressive increase of BCR/ABL(+) cases with age, which are potentially manageable by targeted therapies.

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    ,

    rfoa@bce.uniroma1.it or chiaretti@bce.uniroma1.it.

    , , , , , , , , , , , , , , , , , , , , , , ,

    Source

    Haematologica 98:11 2013 Nov pg 1702-10

    MeSH

    Adolescent
    Adult
    Age Factors
    Child
    Child, Preschool
    Cohort Studies
    Female
    Humans
    Infant
    Italy
    Male
    Middle Aged
    Precursor Cell Lymphoblastic Leukemia-Lymphoma
    Retrospective Studies
    Young Adult

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23716539

    Citation

    Chiaretti, Sabina, et al. "Clinico-biological Features of 5202 Patients With Acute Lymphoblastic Leukemia Enrolled in the Italian AIEOP and GIMEMA Protocols and Stratified in Age Cohorts." Haematologica, vol. 98, no. 11, 2013, pp. 1702-10.
    Chiaretti S, Vitale A, Cazzaniga G, et al. Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. Haematologica. 2013;98(11):1702-10.
    Chiaretti, S., Vitale, A., Cazzaniga, G., Orlando, S. M., Silvestri, D., Fazi, P., ... Foà, R. (2013). Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. Haematologica, 98(11), pp. 1702-10. doi:10.3324/haematol.2012.080432.
    Chiaretti S, et al. Clinico-biological Features of 5202 Patients With Acute Lymphoblastic Leukemia Enrolled in the Italian AIEOP and GIMEMA Protocols and Stratified in Age Cohorts. Haematologica. 2013;98(11):1702-10. PubMed PMID: 23716539.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. AU - Chiaretti,Sabina, AU - Vitale,Antonella, AU - Cazzaniga,Gianni, AU - Orlando,Sonia Maria, AU - Silvestri,Daniela, AU - Fazi,Paola, AU - Valsecchi,Maria Grazia, AU - Elia,Loredana, AU - Testi,Anna Maria, AU - Mancini,Francesca, AU - Conter,Valentino, AU - te Kronnie,Geertruy, AU - Ferrara,Felicetto, AU - Di Raimondo,Francesco, AU - Tedeschi,Alessandra, AU - Fioritoni,Giuseppe, AU - Fabbiano,Francesco, AU - Meloni,Giovanna, AU - Specchia,Giorgina, AU - Pizzolo,Giovanni, AU - Mandelli,Franco, AU - Guarini,Anna, AU - Basso,Giuseppe, AU - Biondi,Andrea, AU - Foà,Robin, Y1 - 2013/05/28/ PY - 2013/5/30/entrez PY - 2013/5/30/pubmed PY - 2014/7/16/medline SP - 1702 EP - 10 JF - Haematologica JO - Haematologica VL - 98 IS - 11 N2 - The outcome of children and adults with acute lymphoblastic leukemia is markedly different. Since there is limited information on the distribution of clinico-biological variables in different age cohorts, we analyzed 5202 patients with acute lymphoblastic leukemia enrolled in the Italian multicenter AIEOP and GIMEMA protocols and stratified them in nine age cohorts. The highest prevalence of acute lymphoblastic leukemia was observed in children, although a second peak was recorded from the 4(th) decade onwards. Interestingly, the lowest incidence was found in females between 14-40 years. Immunophenotypic characterization showed a B-lineage in 85.8% of patients: a pro-B stage, associated with MLL/AF4 positivity, was more frequent in patients between 10-50 years. T-lineage leukemia (14.2%) was rare among small children and increased in patients aged 10-40 years. The prevalence of the BCR/ABL1 rearrangement increased progressively with age starting from the cohort of patients 10-14 years old and was present in 52.7% of cases in the 6th decade. Similarly, the MLL/AF4 rearrangement constantly increased up to the 5(th) decade, while the ETV6/RUNX1 rearrangement disappeared from the age of 30 onwards. This study shows that acute lymphoblastic leukemia in adolescents and young adults is characterized by a male prevalence, higher percentage of T-lineage cases, an increase of poor prognostic molecular markers with aging compared to cases in children, and conclusively quantified the progressive increase of BCR/ABL(+) cases with age, which are potentially manageable by targeted therapies. SN - 1592-8721 UR - https://www.unboundmedicine.com/medline/citation/23716539/full_citation L2 - http://www.haematologica.org/cgi/pmidlookup?view=long&pmid=23716539 DB - PRIME DP - Unbound Medicine ER -