Skip to main content
SpringerLink
Log in

Clinical and prognostic significance of the Philadelphia chromosome in adult patients with acute lymphoblastic leukemia

  • Short Communication
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Summary

Between 1983 and 1991 the Philadelphia chromosome (Ph1) was found in bone marrow and/or peripheral blood cells of 25 adult patients with acute lymphoblastic leukemia (ALL). The Ph1 as sole anomaly was seen in 13 patients, while six patients had additional structural and another six structural and numerical aberrations. Most patients (23/25) received combination chemotherapy according to the BMFT protocols 1/81, 2/84, 3/87, and 4/89. For 25 evaluable patients two early deaths, two treatment failures, two partial remissions (PR), and 19 complete remissions (CR) after phase 1 or 2 of the induction regimen were recorded. Two of these 19 patients who achieved CR are presently disease free, whereas 17 have relapsed after a median duration of remission of 9 months. Actuarial median survival for all patients was 13 months. The probability of continuous complete remission (CCR) after 39 months, as well as that of survival after 40 months, is only 6%. Our results confirm that the presence of the Ph1 is associated with a poor prognosis in adult-ALL patients. Therefore, whenever first CR is obtained and an HLA-identical donor is available, allogeneic bone marrow transplantation (BMT) should be performed at once, the more so, since transplantation in second CR seems to offer no cure. Future studies will have to show whether an intensified cytotoxic therapy can improve the prognosis of Ph1+-ALL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Bloomfield CD, Peterson LC, Yunis JJ, Brunning RD (1977) The Philadelphia chromosome in adults presenting with acute leukemia. A comparison of Ph1+ and Ph1-patients. Br J Haematol 36: 3475

    Google Scholar 

  2. Bloomfield CD, Lindquist L, Brunning RD, Yunis J, Coccia PF (1978) The Philadelphia-chromosome in acute leukemia. Virchows Arch [B] 29: 81

    Google Scholar 

  3. Bloomfield CD, Brunning RD, Smith KA, Nesbit M (1980) Prognostic significance of the Philadelphia-chromosome in acute lymphoblastic leukemia. Cancer Genet Cytogenet 1: 229

    Google Scholar 

  4. Bloomfield CD, Goldman AI, Alimena G, Berger R, Borgström GH, Brandt L, Catovsky D, de la Chapelle A, Dewald GU, Garson OM, Garwicz G, Golomb HM, Hossfeld DK, Lawler SD, Mitelman F, Nilsson P, Pierre RV, Philip P, Prigogina E, Rowley Jd, Sakurei M, Sandberg AA, Secker-Walker LM, Tricot G, Van den Berghe H, van Orshoven A, Vnopio P, Whang-Peng J (1986) Chromosomal abnormalities identify high-risk and low-risk patients with acute lymphoblastic leukemia. Blood 67: 415

    PubMed  Google Scholar 

  5. Bloomfield CD, Secker-Walker LM, Goldman AI, Van den Berghe H, de la Chapelle A, Ruutu T, Alimena G, Garson OM, Golomb HM, Rowley JD, Koneko Y, Whang-Peng J, Prigogina E, Philip P, Sandberg AA, Lawler SD, Mitelman F (1989) Six years' follow-up of the clinical significance of karyotype in acute lymphoblastic leukemia. Cancer Genet Cytogenet 40: 171

    PubMed  Google Scholar 

  6. Bloomfield CD, Wurster-Hill D, Peng G, Le Beau M, Tantravahi R, Testa J, Davey FR, Ellison RR, Cuttner J, Schiffer C, Sobol RE, Lunghofer B, Carey M, Mick R, Arthur D (1990) Prognostic significance of the Philadelphia chromosome in adult acute lymphoblastic leukemia. In: Gale RP, Hoelzer D (eds) Acute lymphoblastic leukemia. Wiley-Liss, pp 101–109

  7. Fletcher JA, Kimball VM, Lynch E, Donelly M, Pavelka K, Gelber RD, Tantravahi R, Sallan SE (1989) Prognostic implications of cytogenetic studies in an intensively treated group of children with acute lymphoblastic leukemia. Blood 74: 2130

    PubMed  Google Scholar 

  8. Forman SJ, O'Donnell MR, Nademanee AP, Snyder DS, Bierman PJ, Schmidt GM, Fahey JL, Stein AS, Parker PM, Blume KG (1987) Bone marrow transplantation for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 70: 587

    PubMed  Google Scholar 

  9. Hoelzer D, Gale RP (1987) Acute lymphoblastic leukemia in adults: recent progress, future directions. Semin Hematol 24: 27

    PubMed  Google Scholar 

  10. Hoelzer D, Thiel E, Löffler H, Bodenstein H, Plaumann L, Büchner T, Urbanitz D, Koch P, Heimpel H, Engelhardt R, Müller U, Wendt FC, Sodomann H, Rühl H, Herrmann F, Kaboth W, Dietzfelbinger H, Pralle H, Lunscken C, Hellriegel KP, Spors S, Nowrousian RM, Fischer J, Fülle H, Mitrou PS, Pfreundschuh M, Görg C, Emmerich B, Queisser W, Meyer P, Labedzki L, Essers U, König H, Mainzer K, Herrmann D, Zwingers T (1984) Intensified therapy in acute lymphoblastic and acute undifferentiated leukemia an adults. Blood 64: 38

    PubMed  Google Scholar 

  11. Hoelzer D, Thiel E, Löffler H, Büchner T, Ganser A, Heil G, Koch P, Freund M, Diedrich H, Rühl H, Maschmeyer G, Lipp T, Nowrousian MR, Burkert M, Gerecke D, Pralle H, Müller U, Lunscken C, Fülle H, Ho AD, Küchler R, Busch FW, Schneider W, Görg C, Emmerich B, Braumann D, Vaupel HA, von Paleske A, Bartels H, Neiss A, Messerer D (1988) Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood 71: 123

    PubMed  Google Scholar 

  12. Horowitz MM, Messerer D, Hoelzer D, Gale RP, Neiss A, Atkinson K, Barrett AJ, Büchner T, Freund M, Heil G, Hiddemann W, Kolb H-J, Löffler H, Marmont AM, Maschmeyer G, Rimm AA, Rozman C, Sobocinski KA, Speck B, Thiel E, Weisdorf DJ, Zwaan FE, Bortin MM (1991) Chemotherapy compared with bone marrow transplantation for adults with acute lymphoblastic leukemia in first remission. Ann Intern Med 115: 13

    PubMed  Google Scholar 

  13. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observation. J Am Stat Assoc 53: 457

    Google Scholar 

  14. Maddox AM, Keating MJ, Trujillo J, Cork A, Youness E, Ahearn MJ, McCredie KM, Freireich EJ (1983) Philadelphia chromosome-positive adult acute leukemia with monosomy of chromosome number seven: a subgroup with poor response to therapy. Leukemia Res 7: 509

    Google Scholar 

  15. Pui CH, Raimondi SC, Dodge RK, Rivera GK, Fuchs LAH, Abromowitch M, Look AT, Furman WL, Christ WM, Williams DL (1989) Prognostic improtance of structural chromosomal abnormalities in children with hyperdiploid acute lymphoblastic leukemia. Blood 73: 1963

    PubMed  Google Scholar 

  16. Ribeiro RC, Abromowitch M, Raimondi SC, Murphy SB, Behm F, Williams DL (1987) Clinical and biological hallmarks of the Philadelphia chromosome in childhood acute lymphoblastic leukemia. Blood 70: 948

    PubMed  Google Scholar 

  17. Seabright M (1971) A rapid banding technique for human chromosomes. Lancet 2: 971

    Google Scholar 

  18. Third International Workshop on Chromosomes in Leukemia (1981) Clinical significance of chromosomal abnormalities in acute lymphoblastic leukemia. Cancer Genet Cytogenet 4: 111

    Google Scholar 

  19. Sixth International Workshop on Chromosomes in Leukemia (1987) Chromosomal abnormalities and their clinical significance in acute lymphoblastic leukemia. Cancer Res 43: 868

    Google Scholar 

  20. Wingard JR, Piantadosi S, Santos GW, Huibert RS, Vriesendorp HM, Yeager AM, Burns WH, Ambinder RF, Braine HG, Elfenbein G, Jones RJ, Kaizer H, May WS, Rowley SD, Sensenbrenner LL, Stuart RK, Tuschka PJ, Vogelsang GB, Wagner JE, Beschorner WE, Brookmeyer R, Farmer ER (1990) Allogeneic bone marrow transplantation for patients with high-risk acute lymphoblastic leukemia. J Clin Oncol 8: 820

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abtlg. Hämatologie/Onkologie, Universitätskrankenhaus Eppendorf, Martinistrasse 52, W-2000, Hamburg 20, Federal Republic of Germany

    G. Götz, H. -J. Weh, T. A. Walter & D. K. Hossfeld

  2. Allgemeines Krankenhaus St. Georg, Lohmühlenstrasse 5, W-2000, Hamburg 1, Federal Republic of Germany

    R. Kuse

  3. I. Medizinische Klinik, Langenbeckstrasse 1, W-6500, Mainz, Federal Republic of Germany

    K. Kolbe

  4. Klinikum der Albert-Ludwigs-Universität, Hugstetter Strasse 55, W-7800, Freiburg, Federal Republic of Germany

    G. Dölken

  5. Krankenhaus Moabit, Turmstrasse 21, W-1000, Berlin 21, Federal Republic of Germany

    K. P. Hellriegel

  6. Zentrum Innere Medizin, Klinikum der Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, W-6000, Frankfurt 70, Federal Republic of Germany

    D. Hoelzer

Authors
  1. G. Götz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. -J. Weh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. A. Walter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Kuse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Kolbe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Dölken
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. P. Hellriegel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. Hoelzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D. K. Hossfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Götz, G., Weh, H.J., Walter, T.A. et al. Clinical and prognostic significance of the Philadelphia chromosome in adult patients with acute lymphoblastic leukemia. Ann Hematol 64, 97–100 (1992). https://doi.org/10.1007/BF01715353

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01715353

Key words

Search

Navigation