The poor prognosis of low hypodiploidy in adults with B-cell precursor acute lymphoblastic leukaemia is restricted to older adults and elderly patients

Ribera J; Granada I; Morgades M; Vives S; Genescà E; González C; Nomdedeu J; Escoda L; Montesinos P; Mercadal S; Coll R; González-Campos J; Abella E; Barba P; Bermúdez A; Gil C; Tormo M; Pedreño M; Martínez-Carballeira D; Hernández-Rivas JM; Orfao A; Martínez-López J; Esteve J; Bravo P; Garcia-Guiñon A; Debén G; Moraleda JM; Queizán JA; Ortín X; Moreno MJ; Feliu E; Solé F; Ribera JM. PETHEMA Group; Spanish Society of Haematology.


The prognostic significance of low-hypodiploidy has not been extensively evaluated in minimal residual disease (MRD)-oriented protocols for adult acute lymphoblastic leukaemia (ALL). We analysed the outcome of hypodiploid adult ALL patients treated within Programa Espanol de Tratamientos en Hematologia (PETHEMA) protocols. The 5-year cumulative incidence of relapse (CIR) of low-hypodiploid B-cell precursor (BCP)-ALL was significantly higher than that of high-hypodiploids (52% vs. 12%, P = 0.013). Low-hypodiploid BCP-ALL patients aged <= 35 years showed superior survival (71% vs. 21%, P = 0.026) and lower 5-year CIR (17% vs. 66%, P = 0.090) than low-hypodiploids aged >35 years. Older adults and elderly low-hypodiploid BCP-ALL patients show dismal prognosis although achieving an end-induction good MRD response.

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