Leucemia Linfoblástica Aguda (LLA)

  • Ribera Group_04_2018
ICO - Germans Trias i Pujol

Josep Carreras Leukaemia Research Institute
Edifici IMPPC
Can Ruti Campus
Ctra de Can Ruti, Camí de les Escoles s/n
08916 Badalona, Barcelona, Spain




Our research is focused on Acute lymphoblastic Leukemia (ALL) disease, including B-cell precursor and T-precursor ALL. We want to resolve questions that require a full range of research from from basic to clinical. We aim to provide the physician with new tools, by using basic research data that will have an impact on healthcare, in order to improve survival rates in patients with this type of leukaemia.


Acute Lymphoblastic Leukemia is still a non-curable neoplasia mainly in adult patients. The survival rates for ALL are much lower in adults than in children. The reasons for this survival difference lie largely in the higher frequency of poor prognosis subtypes of ALL in adults and a poorer tolerance of the treatment as age increases. Except for selected subgroups (i.e., Ph+ ALL), the current therapeutic protocols for ALL do not take into account the differences in the molecular background of the disease, and few new alternative therapies are only available in refractory or resistant ALL. Therefore, if we want to improve the survival of patients with ALL we first need to obtain detailed and relevant molecular information to enable doctors to accurately define the risk and decide on the treatment. Secondly, we need to have specific therapeutic alternatives available to apply to these new oncogenetic ALL subgroups.

Main Research Lines:

The current research of the group at the IJC Institute can be divided in two main areas:

1: Clinical research: Design and analysis of the results of the Spanish treatment protocols on adult ALL in the setting of the Spanish PETHEMA group (Programa Español de Tratamientos en Hematología).

2. Biologic and translational research

The ALL Group is currently evaluating the frequency and prognostic significance of new genetic markers in B- and T- lineage ALL. The results of this study, which are in line with the results found by other ALL working groups, will be applied in the new therapeutic protocols in ALL of the PETHEMA group.

In addition, we want to assess the anti-leukemic effect of the available drugs that specifically target candidate genes in an in vivo model. We also want to check if copy number alterations (CNAs) identified in other blood neoplasias such as; Acute Myeloblastic Leukaemia (AML), Non-Hodgkin Lymphoma (NHL) and Chronic Myeloid Leukaemia (CLL), or in solid cancers such as Melanoma and Breast Cancer, could also have an impact on ALL. We expect that the results obtained, will be used to re-classify ALL patients into different oncogenetic subgroups according to the predicted treatment response and the specific target therapy to be applied.

The identification of clonal heterogeneity in ALL at the time of diagnosis has introduced a high order of complexity to the disease. It is this clonal heterogeneity that is responsible for patient’s relapses, in which treatment has failed. Future projects in the group will be focused on the characterization of leukemic cells resistant to treatment using a genetic and functional approach.



Selected publications

Gachet S, El-Chaar T, Avran D, Genesca E, Catez F, Quentin S, Delord M, Thérizols G, Briot D, Meunier G, Hernandez L, Pla M, Smits WK, Buijs-Gladdines JG, Van Loocke W, Menschaert G, André-Schmutz I, Taghon T, Van Vlierberghe P, Meijerink JP, Baruchel A, Dombret H, Clappier E, Diaz JJ, Gazin C, de Thé H, Sigaux F, Soulier J

Deletion 6q Drives T-cell Leukemia Progression by Ribosome Modulation.

Cancer Discov Dic 2018, 8 (12) 1614-1631. Epub 28 Sep 2018
Deletion of chromosome 6q is a well-recognized abnormality found in poor-prognosis T-cell acute lymphoblastic leukemia (T-ALL). Using integrated genomic approaches, we identified two candidate haploinsufficient genes contiguous at 6q14,
Más información
Genescà E, Lazarenkov A, Morgades M, Berbis G, Ruíz-Xivillé N, Gómez-Marzo P, Ribera J, Juncà J, González-Pérez A, Mercadal S, Guardia R, Artola MT, Moreno MJ, Martínez-López J, Zamora L, Barba P, Gil C, Tormo M, Cladera A, Novo A, Pratcorona M, Nomdedeu J, González-Campos J, Almeida M, Cervera J, Montesinos P, Batlle M, Vives S, Esteve J, Feliu E, Solé F, Orfao A, Ribera JM

Frequency and clinical impact of CDKN2A/ARF/CDKN2B gene deletions as assessed by in-depth genetic analyses in adult T cell acute lymphoblastic leukemia.

J Hematol Oncol 24 Jul 2018, 11 (1) 96. Epub 24 Jul 2018
Recurrent deletions of the CDKN2A/ARF/CDKN2B genes encoded at chromosome 9p21 have been described in both pediatric and adult acute lymphoblastic leukemia (ALL), but their prognostic value remains controversial, with limited data on adult T-ALL. Here, we investigated the presence of homozygous and heterozygous deletions of the CDKN2A/ARF and CDKN2B genes in 64 adult T-ALL patients enrolled in two consecutive trials from the Spanish PETHEMA group. Alterations in CDKN2A/ARF/CDKN2B were detected in 35/64 patients (55%). Most of them consisted of 9p21 losses involving homozygous deletions of the CDKNA/ARF gene (26/64), as confirmed by single nucleotide polymorphism (SNP) arrays and interphase fluorescence in situ hybridization (iFISH). Deletions involving the CDKN2A/ARF/CDKN2B locus correlated with a higher frequency of cortical T cell phenotype and a better clearance of minimal residual disease (MRD) after induction therapy. Moreover, the combination of an altered copy-number-value (CNV) involving the CDKN2A/ARF/CDKN2B gene locus and undetectable MRD (≤ 0.01%) values allowed the identification of a subset of T-ALL with better overall survival in the absence of hematopoietic stem cell transplantation.
Más información
Ribera JM, García O, Moreno MJ, Barba P, García-Cadenas I, Mercadal S, Montesinos P, Barrios M, González-Campos J, Martínez-Carballeira D, Gil C, Ribera J, Vives S, Novo A, Cervera M, Serrano J, Lavilla E, Abella E, Tormo M, Amigo ML, Artola MT, Genescà E, Bravo P, García-Belmonte D, García-Guiñón A, Hernández-Rivas JM, Feliu E

Incidence and outcome after first molecular versus overt recurrence in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia included in the ALL Ph08 trial from the Spanish PETHEMA Group.

Cancer 23 Abr 2019, . Epub 23 Abr 2019
Disease recurrence occurs in 20% to 40% of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who are treated with chemotherapy and tyrosine kinase inhibitors (TKIs). In the current study, the authors report the incidence, treatment, and outcome after first disease recurrence in young and older adults treated in the ALL Ph08 trial (ClinicalTrials.gov identifier NCT01491763).
Más información
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

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

Br. J. Haematol. 27 Mar 2019, . Epub 27 Mar 2019
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 Español de Tratamientos en Hematología (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.
Más información
Ribera J, Morgades M, Zamora L, Montesinos P, Gómez-Seguí I, Pratcorona M, Sarrà J, Guàrdia R, Nomdedeu J, Tormo M, Martínez-Lopez J, Hernández-Rivas JM, González-Campos J, Barba P, Escoda L, Genescà E, Solé F, Millá F, Feliu E, Ribera JM

Prognostic significance of copy number alterations in adolescent and adult patients with precursor B acute lymphoblastic leukemia enrolled in PETHEMA protocols.

Cancer 1 Nov 2015, 121 (21) 3809-17. Epub 20 Jul 2015
Some copy number alterations (CNAs) have independent prognostic significance for adults with acute lymphoblastic leukemia (ALL).
Más información
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Current projects

Comparison of next generation sequencing (NGS) and high sensitivity citometry to asses minimal residual disease (MRD) in childhood and adult acute lymphoblastic leukemia

Responsable:José María Ribera
Fecha de inicio:01/01/2015
Fecha de finalización:31/12/2017

Identification of copy number alterations as targets for available drugs involved in T-ALL leukemogenesis and prognosis

Responsable:Eulàlia Genesca
Fecha de inicio:01/01/2014
Fecha de finalización:31/12/2016

Exploring Mechanisms of Resistance in Adult and Pediatric T-Acute Lymphoblastic Leukemia;(A.Bigas,IMIM)&(J.M.Ribera-E.Genescà,IJC)

Responsable:José María Ribera
Fecha de inicio:01/11/2016
Fecha de finalización:31/10/2021

HARMONY - Healthcare Alliance for Resourceful Medicines Offensive against Neoplasms in hematology

Responsable:José María Ribera
Código:116026 HARMONY H2020 JTI-IMI2 2015-06
Fecha de inicio:01/01/2017
Fecha de finalización:31/12/2021

AMGEN Clinical Research Support

Responsable:José María Ribera
Código:Curs AMGEN ALL
Fecha de inicio:01/01/2018
Fecha de finalización:31/12/2018

Apoyo científico / Docente Solicitud de ayuda a la investigacion en leucemia aguda linfoblastica

Responsable:José María Ribera
Fecha de inicio:01/01/2017
Fecha de finalización:31/12/2018

Estudi observacional prospectiu de tractament adaptat al risc de la LMA i les SMD a Catalunya

Responsable:José María Ribera
Fecha de inicio:01/04/2017
Fecha de finalización:31/12/2019

Previous projects

Study of the frequency and prognostic significance of Copy Number Alterations and CpG island methylation status in adult B-precursor Acute Lymphoblastic Leukemia patients enrolled in risk-adapted protocols of the Spanish PETHEMA Group

Responsable:José María Ribera
Fecha de inicio:01/01/2011
Fecha de finalización:30/06/2014

Grup de Recerca Emergent: Grup de Recerca d'estudi de les neoplàsies hematològiques del IJC-Campus Trias i Pujol

Responsable:Francesc Solé
Fecha de inicio:01/01/2015
Fecha de finalización:31/12/2017