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KMID : 0939920020340040289
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대한암학회지
2002 Volume.34 No. 4 p.289 ~ p.295
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The Outcome of Philadelphia Chromosome-Positive Adult ALL: Characteristics and Prognosis
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Kyoo Hyung Lee/Hun Ho Song
Je Hwan Lee/Byung Min Jeon/Jung Hee Lee/Eul Ju Seo/Chan Jeoung Park/Hyun Sook Chi/Jung Shin Lee/Woo Kun Kim/Kyoo Hyung Lee
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Abstract
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Purpose: The Philadelphia (Ph) chromosome is a well- known chromosome abnormality in adults with B-lineage ALL, and is associated with a poor prognosis. This study compared the clinical manifestations and prognosis in adult Ph-positive and Ph-negative ALL patients.
Materials and methods: We retrospectively analyzed the clinical records of adult patients newly diagnosed as B-lineage ALL, between January 1995 and February 2001. Fifty five patients were included in this study. We divided the patients into Ph-positive and Ph-negative groups.
Results: Eighteen of the 55 patients (32.7%) were found to have the Ph chromosome. At initial diagnosis, the Ph-positive patients had higher circulating leukocyte counts, lower platelet counts and had a greater tendency to bleed, than the Ph-negative group. The complete remission rates were 83.3% and 83.8% for the Ph-positive and the Ph-negative groups, respectively. Four of the Ph-positive, and 13 of the Ph-negative, patients underwent allogenic bone marrow transplantation. The median follow-up for the surviving patients was 39.3 months. The three-year survival rates were 10.4% and 51.8% for the Ph-positive and the Ph-negative groups, respectively. The median disease-free survival was 7.7 months for the Ph-positive group, but did not reach the median value in the Ph-negative group. Among the Ph-positive patients, age was the only factor that had an impact on the disease outcome.
Conclusion: In adult B-lineage ALL, the Ph-positive patients had similar complete remission rates to other patients; however, the remission was of shorter duration, with a higher relapse rate in the Ph-positive patients. More effective treatments are needed to improve the survival of the Ph-positive patients.
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KEYWORD
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Adult B-lineage ALL, Philadelphia chromosome, Prognosis,
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