Prognostic impact of t(1;19)/ TCF3–PBX1 in childhood acute lymphoblastic leukemia in the context of Berlin–Frankfurt–Münster-based protocols

Abstract

Historically, t(1;19)(q23;p13.3) has been related to pre-B acute lymphoblastic leukemia (ALL) and associated with a poor prognosis. Current treatments have overcome this dismal outcome, but advantages in survival for the unbalanced group have been reported. We compared the outcome of balanced and unbalanced der(19)t(1;19) cases and also patients with t(1;19)/TCF3–PBX1 versus patients without this translocation, to assess its prognostic value. From January 1990 to December 2010, t(1;19)(q23;p13)/TCF3–PBX1 was detected in 48 cases. Patients were treated with Berlin–Frankfurt–Münster (BFM)-based protocols and classified into balanced (n = 17) and unbalanced (n = 23) groups. The probability of event-free survival (pEFS) (standard error) of patients with t(1;19)/TCF3–PBX1 was 85% (6%), for the unbalanced group 78% (10%), and 88% (8%) for the balanced. The pEFS of patients with t(1;19)/TCF3–PBX1 was significantly superior to that of patients without t(1;19)/TCF3–PBX1 (p-value <0.0001). Patients with t(1;19)/TCF3–PBX1 presented a good outcome with no differences between balanced and unbalanced subgroups. Thus, risk-adjustment therapy would not be necessary for cases with t(1;19)/TCF3–PBX1.

Keywords:

• Acute lymphoblastic leukemia
• t(1;19)
• E2A–PBX1 fusion transcript
• childhood
• prognostic value

Acknowledgements

The authors are indebted to Adriana Medina and Alejandra Rampazzi for their valuable technical assistance.

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