Frequency of p190 and p210 <i>BCR-ABL</i> rearrangements and survival in Brazilian adult patients with acute lymphoblastic leukemia

Azevedo, Ilana de França; Silva Júnior, Rui Milton Patrício da; Vasconcelos, Audrey Violeta Martins de; Neves, Washington Batista das; Melo, Fárida Coeli de Barros Correia; Melo, Raul Antônio Morais

doi:10.1016/j.bjhh.2014.07.016

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Original Articles • Rev. Bras. Hematol. Hemoter. 36 (5) • Sep-Oct 2014 • https://doi.org/10.1016/j.bjhh.2014.07.016 copy

Frequency of p190 and p210 BCR-ABL rearrangements and survival in Brazilian adult patients with acute lymphoblastic leukemia

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

This study investigated the occurrence of the p190 and p210 break point clusterregion-Abelson (BCR-ABL) rearrangements in adults with acute lymphoblastic leukemia and possible associations with clinical and laboratory characteristics and survival.

Methods:

Forty-one over 18-year-old patients with acute lymphoblastic leukemia of both genders followed-up between January 2008 and May 2012 were included in this study. Clinical and laboratory data were obtained from the medical charts of the patients. Reverse transcription polymerase chain reaction (RT-PCR) using specific primers was employed to identify molecular rearrangements.

Results:

At diagnosis, the median age was 33 years, and there was a predominance of males (61%). The most common immunophenotype was B lineage (76%). BCR-ABL rearrangements was detected in 14 (34%) patients with the following distribution: p190 (28%), p210 (50%) and double positive (22%). Overall survival of patients with a mean/median of 331/246 days of follow up was 39%, respectively, negative BCR-ABL (44%) and positive BCR-ABL (28%).

Conclusion:

These results confirm the high frequency of BCR-ABL rearrangements and the low survival rate of adult Brazilian patients with acute lymphoblastic leukemia.

Acute biphenotypic leukemia; Adult; BCR-ABL ; Survival analysis

Clinical features
Age (Years) – n (%)
	18–34	23 (56)
	35–60	14 (34)
	>60	4 (10)
	Median (range)	33 (19–72)
Gender – n (%)
	Male	25 (61)
	Female	16 (39)
Leucocytes (x10⁹/L)
	Median (range)	47 (0.3–570.5)
Lymphoblasts PB (%)
	Median (range)	78 (0–98)
Platelets (x10⁹/L)
	Median (range)	47 (8–571)
Hemoglobin (g/dL)
	Median (range)	8.5 (2.7–12.9)
Immunophenotype – n (%)
	B-ALL	31 (76)
	T-ALL	9 (22)
	Not done	1 (2)

Variable		BCR-ABL^- (n = 27)	BCR-ABL⁺ (n = 14)	BCR-ABL⁺ p190 (n = 4)	BCR-ABL⁺ p210 (n = 7)	BCR-ABL⁺ p190/p210 (n = 3)
Age (years)
	Median (range)	35 (19–72)	38 (20–72)	45 (22–61)	35 (20–72)	34 (20–48)
Leucocytes (×10⁹/L)
	Median (range)	30.4 (1–492)	77.1 (0.3–570)	76.6 (0.3–378)	96.0 (6.7–570)	7.7 (4.2–298.8)
Platelets (×10⁹/L)
	Median (range)	41 (8–571)	69 (18–213)	175.5 (18–213)	60 (27–155)	70 (60–112)
Lymphoblasts (%)
	Median (range)	78 (0–97)	80 (0–98)	75 (0–93)	85 (31–98)	36 (3–94)
Immunophenotype^a a n = 40. – n (%)
	B-ALL	21 (78.0)	10 (71.5)	4 (100.0)	3 (43.0)	3 (100.0)
	T-ALL	5 (22.0)	4 (28.5)	0 (0)	4 (57.0)	0 (0)

Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular R. Dr. Diogo de Faria, 775 cj 114, 04037-002 São Paulo/SP/Brasil, Tel. (55 11) 2369-7767/2338-6764 - São Paulo - SP - Brazil
E-mail: secretaria@rbhh.org

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[1] *Corresponding author at: Laboratório de Biologia Molecular, Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Rua Joaquim Nabuco, 171, Graças, 52011-000 Recife, PE, Brazil. E-mail address: ilanafranca87@gmail.com (I. de França Azevedo).