P210 breakpoint is associated with less minimal residual disease compared to p190 breakpoint in acute lymphoblastic leukemia patients with Philadelphia chromosome

Abstract

Introduction: The Philadelphia chromosome is the most common cytogenetic abnormality in adult patients with acute lymphoblastic leukemia. In addition to its role in treatment choice, evaluation of Philadelphia chromosome is also important to monitor the minimal residual disease. In this study, we aim to study the differences of minimal residual disease status between 2 breakpoint regions (p190 and p210) in adult patients with acute lymphoblastic leukemia.
Material and Method: The data of 205 acute lymphoblastic leukemia patients whose genetic evaluations were performed at our center between March 2010 and February 2019 were retrospectively analyzed.
Results: Philadelphia chromosome was observed in 30 (14.6%) patients. In 75% of the patients who had p210 breakpoint at the time of diagnosis, minimal residual disease was negative after 2 cycles of chemotherapy whereas only 42.8% of the patients who had p190 at the time of diagnosis, minimal residual disease was negative after 2 cycles of chemotherapy. The frequency of Philadelphia chromosome was the highest in 51-60 years age group and it was the least in 18-39 age group in adult B cell acute lymphoblastic leukemia patients.
Conclusion: To the best of our knowledge, this is the first study which evaluated the minimal residual disease status of Philadelphia positive acute lymphoblastic leukemia patients by classifying them into 2 groups according to 2 breakpoints (p190 and p210) in the BCR locus. In our study, we found that p190 breakpoint is associated with less minimal residual disease negative status compared to the patients with p210 breakpoint, therefore more augmented therapies may be preferred in patients with p190 breakpoint compared to therapies of patients with p210 breakpoint.

Keywords

• Philadelphia chromosome,minimal residual disease,p210 breakpoint,p190 breakpoint

Philadelphia kromozomu olan akut lenfoblastik lösemi hastalarında p210 kırılma noktası P190 kırılma noktasına göre daha az minimal kalıntı hastalığı ile ilişkilidir

Abstract

Giriş: Philadelphia kromozomu, akut lenfoblastik lösemili erişkin hastalarda en sık görülen sitogenetik anormalliktir. Philadelphia kromozomunun değerlendirilmesi, tedavi seçimindeki rolüne ek olarak minimal rezidüel hastalığı izlemek için önemlidir. Bu çalışmada akut lenfoblastik lösemili yetişkin hastalarda 2 kırılma noktası (p190 ve p210) arasındaki minimal rezidüel hastalığı durumu farklılıklarını araştırmayı amaçladık.
Gereç ve Yöntem: Mart 2010-Şubat 2019 tarihleri arasında merkezimizde genetik tetkikleri yapılan 205 akut lenfoblastik lösemili hastasının verileri retrospektif olarak incelendi.
Bulgular: 30 hastada (%14,6) Philadelphia kromozomu gözlendi. Tanı anında p210 kırılma noktası olan hastaların %75’inde 2 siklus kemoterapi sonrasında minimal rezidüel hastalığı negatif hale gelirken, tanı anında p190 kırılma noktası olan hastaların sadece %42,8’inde 2 siklus kemoterapi sonrasında minimal rezidüel hastalığı negatif hale geldi. Philadelphia kromozomu sıklığı 51-60 yaş grubunda en yüksek, 18-39 yaş grubunda en az idi.
Sonuç: Literatür taramamıza göre bu çalışma, Philadelphia pozitif akut lenfoblastik lösemili hastalarının minimal rezidüel hastalığı durumunu kırılma noktalarına göre (p190 ve p210) 2 gruba ayırarak değerlendiren ilk çalışmadır. Çalışmamızda BCR lokusundaki p190 kırılma noktasının, p210 kırılma noktasına sahip hastalara kıyasla daha az minimal rezidüel hastalığı negatif durum ile ilişkili olduğunu bulduk, bu nedenle p190 kırılma noktası olan hastalarda p210 kırılma noktası olan hastalarda kullanılan tedavilere kıyasla daha fazla yoğun tedaviler tercih edilebilir.

Keywords

• Philadelphia kromozomu,minimal rezidüel hastalık,p210 kırılma noktası,p190 kırılma noktası

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