Внутрихромосомная амплификация 21q (iAMP21) как маркер неблагоприятного прогноза при острых лимфобластных лейкозах из В-линейных предшественников

Статья в Elpub

Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2018; 17: 37-45

Внутрихромосомная амплификация 21q (iAMP21) как маркер неблагоприятного прогноза при острых лимфобластных лейкозах из В-линейных предшественников

Ольшанская Ю.В. , Казакова А.Н. , Червова А.А. , Румянцева Ю.В. , Литвинов Д.В. , Зеркаленкова Е.А. , Солдаткина О.И. , Лагойко С.Н. , Мякова Н.В. , Хенце Г. ., Румянцев А.Г. , Карачунский А.И.

https://doi.org/10.24287/1726-1708-2018-17-1-37-45

Аннотация

Детские острые лимфобластные лейкозы из В-линейных предшественников (ВП-ОЛЛ) с внутрихромосомной амплификацией участка длинного плеча хромосомы 21 (iAMP21 - intrachromosomal amplification of chromosome 21) имеют крайне неблагоприятный прогноз при терапии согласно группе стандартного риска преимущественно за счет высокой частоты развития рецидивов. Терапия в соответствии с высокой группой риска кардинально меняет прогноз заболевания. В нашем исследовании проанализированы клинические особенности и результаты терапии детей с ВП-ОЛЛ и iAMP21, получавших лечение в рамках оригинального национального протокола лечения ОЛЛ у детей Москва-Берлин 2008 (ALL-MВ 2008). Большинство пациентов было стратифицировано в группу стандартного и промежуточного рисков. При ВП-ОЛЛ с iAMP21 7-летняя бессобытийная выживаемость составила 0,48  0,24 против 0,87  0,2 в группе остальных пациентов; кумулятивная вероятность развития рецидива - 0,41  0,24 и 0,07  0,2 соответственно. Данная группа ВП-ОЛЛ требует изменения подхода к стратификации на группы риска и поиска новых подходов к терапии. Для точного и своевременного выявления iAMP21 необходимо исследование методом FISH в дебюте заболевания.

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Pediatric Hematology/Oncology and Immunopathology. 2018; 17: 37-45

Intrachromosomal amplification of chromosome 21 (iAMP21) is the marker of unfavorable prognosis in childhood B-cell precursor acute lymphoblastic leukemia

Olshanskaya Yu. V., Kazakova A. N., Chervova A. A., Rumiantseva J. V., Litvinov D. V., Zerkalenkova E. A., Soldatkina O. I., Lagoiko S. N., Myakova N. V., Henze G. , Rumiantsev A. G., Karachunskii A. I.

https://doi.org/10.24287/1726-1708-2018-17-1-37-45

Abstract

Childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL) with intrachromosomal amplification of chromosome 21 (iAMP21) has very unfavorable prognosis when treated according as standard risk group, mainly due to high risk of relapce. The outcome is improoving dramatically when the patients were treated as high risk. In our study we analyzed clinical parameters and outcome in children with BCP-ALL and iAMP21 according to trial Moscow-Berlin 2008 (ALL-MB 2008). The majority of patients were stratified in standard and intermediate risk group. Seven years event free survival (EFS) in patients with iAMP21 and without iAMP21 was 0.48 ± 0.24 and 0,87 ± 0,2 respectively with cumulative incidence of relapse 0.41 ± 0.24 и 0.07 ± 0.2. BCP-ALL with iAMP21 needs some changes in current stratification strategy and new approaches to treatment. For faster and accurate detection of iAMP21 evaluation by FISH technique must be applied.

References

3. Dubé I.D., el-Solh H. An apparent tandem quadruplication of chromosome 21 in a case of childhood acute lymphoblastic leukemia. Cancer Genet Cytogenet 1986; 23 (3): 253-6.

14. Ryan S.L., Matheson E., Grossmann V., Sinclair P., Bashton M., Schwab C., et al. The role of the RAS pathway in iAMP21-ALL. 2016; 30 (9): 1824-31.

15. Harrison C.J. Blood Spotlight on iAMP21 acute lymphoblastic leukemia (ALL), a high-risk pediatric disease. Blood 2015; 125 (9): 1383-6.