The Prognostic Impact of the Karyotype in Patients with Acute Lymphoblastic Leukemia

Background and Objective: Acute lymphoblastic leukemia (ALL), is characterized by uncontrolled precursor lymphocyte proliferation. Chromosomal abnormalities have been found in 60–85% of ALL patients. The aim of our work was to determine the chromosomal abnormalities and to evaluate the prognostic value of cytogenetic findings in a cohort of ALL patients.
Method: The study included 36 patients with ALL from Hematology Clinics Tg. Mures, Romania. Cytogenetic analyses were done on bone marrow cultures according to standard methods.
Results: We identified 22 cases (71%) with cytogenetic abnormalities. In our study, the frequency of chromosomal abnormalities was 50% in children and 85% in adults. The most common clonal karyotype aberration in ALL patients was numerical chromosomal abnormalities, detected in 62% of cases. Structural chromosomal abnormalities were found in 38% of our cases and were represented by translocations and deletions. We included our patients in different cytogenetic risk groups: 2 patients in low cytogenetic risk group, 23 in intermediate cytogenetic risk and 6 in severe cytogenetic risk group. We did not find a statistically significant difference in the median overall survival (OS) between the three cytogenetic risk groups (p = 0.863).There was a significantly better OS in patients who had a normal karyotype compared to those who had chromosomal abnormalities (p = 0.008).
Conclusion: Our study highlights the importance of cytogenetic analysis as an important prognostic factor in ALL

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