Combination of IKZF1 deletion and early molecular response show significant roles on prognostic stratification in Philadelphia chromosome-positive acute lymphoblastic leukemia patients

Abstract

We retrospectively analyzed the samples collected from 66 patients with Ph⁺ALL enrolled on ChiCTR-TNRC-09000309 clinical trial. CR rate was 95.5%, and estimated 2-year OS and DFS were 51.7 ± 11.7% and 26.9 ± 11.6%, 3-year OS and DFS were 31.6 ± 12.0% and 23.4 ± 11.6%. By combining IKZF1 deletion and early molecular responses, we redefined the patients as low, intermediate, and high risk 3 groups separately. Patients with double negative in IKZF1 and early molecular response experienced significant superior survival, while patients with double positive would have the worst outcome, and patients who were one or the other with IKZF1 deletion or MRD status had intermediate outcome. Significant differences were found among 3 groups in regard to both OS (p < .001) and DFS (p < .001). Our findings suggest that Ph⁺ALL is a heterogeneous group of diseases with significantly different prognosis. Combination of IKZF1 deletion and MRD status enable better risk stratification of patients for assignment to optimal therapeutic strategies.

Keywords:

• Philadelphia chromosome positive acute lymphoblastic leukemia
• IKZF1 deletion
• minimal residual disease
• prognostic stratification

Acknowledgements

We would like to thank all of the participants in this study, include patients, nurses, and laboratory technicians for their contributions. This study is supported by the Grant of National Public Health Grand Research Foundation (No. 201202017) and the Grant of Sichuan Science and Technology Key Research and Development Project, the Ministry of Science and Technology of Sichuan, China (Grant No. 2017SZ0051).

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2017.1406933.