Incidence, clinical and biological characteristics and outcome of secondary acute lymphoblastic leukemia after solid organ or hematologic malignancy

Abstract

Acute lymphoblastic leukemia (ALL) following solid organ or hematologic malignancy (secondary ALL, s-ALL) is not well characterized. We analyzed the characteristics and outcome of patients with s-ALL and compared them with those of patients with de novo- ALL. Of 448 patients, 24 (5%) had previous neoplasia. Sixteen patients had received previous cytotoxic therapy (therapy-associated ALL, t-ALL), and eight had not (antecedent-malignancy ALL, am-ALL). Except for more advanced age in patients with s-ALL, no statistically significant differences were observed in WBC count, CNS involvement, immunophenotype or cytogenetics between the groups, nor in complete remission (t-ALL: 94%; am-ALL: 75%; de novo-ALL: 85%), 3-year remission duration (58%; 50%; 72%), overall survival (71%; 38%; 60%) or event-free survival (53%, 38%; 53%). Our study did not show poor clinical or cytogenetic features or inferior outcome in ALL patients with antecedent neoplastic disease, irrespective of the type of treatment received for the neoplasia.

Keywords::

• Acute lymphoblastic leukemia
• cytogenetics
• prognosis
• secondary

Acknowledgements

This work was supported in part by grants from the Red Temática de Investigación Cooperativa en Cáncer (RTICC, FEDER) (RD12/0036/0029); 2014 SGR225 (GRE) Generalitat de Catalunya,PI14/01971 from Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, and economical support from Fundació Internacional Josep Carreras and Obra Social “la Caixa,” Spain.

The authors would like to thank the following Spanish institutions, physicians and data managers that have participated in the study: Institut Català d’Oncologia-Hospital Josep Trueta, Girona (Nicholas Kelleher, David Gallardo, Ramon Guàrdia), Institut Català d’Oncologia-Hospital Germans Trias i Pujol, Badalona (Josep-Maria Ribera, Olga Garcia), Hospital de Sant Pau, Barcelona (Salut Brunet), Hospital del Mar, Barcelona (Eugènia Abella), Hospital General Universitario, Alicante (Cristina Gil, Pacual Fernández Abellán), Hospital General de Castellón, Castellón (Raimundo García Boyero), Hospital General Universitario de Valencia, Valencia (Magdalena Sánchez Delgado), Hospital Mútua de Terrassa, Terrassa (Ferran Vall-Llovera), Hospital Puerta del Mar, Cádiz (Victoria Martín Reina), Hospital Universitario Virgen del Rocío, Sevilla (José González-Campos), Hospital Doce de Octubre, Madrid (María-Pilar Martínez, Carlos Grande), Hospital Clínico Universitario, Salamanca (Jesús-María Hernández Rivas), Hospital Madrid Norte Sanchinarro, Madrid (Alfons Serrano), Hospital Ramón y Cajal, Madrid (María Calbacho), Hospital Central de Asturias, Oviedo (Teresa Bernal), Hospital Universitario La Fe, Valencia (Pau Montesinos), Hospital Virgen de la Concha, Zamora (Magdalena Sierra), Hospital Arnau de Vilanova, Lleida (Antoni García Guiñón), Hospital Gregorio Marañón, Madrid (Jorge Gayoso, Pascual Balsalobre), Hospital Infanta Leonor, Madrid (José-Ángel Hernández Rivas), Hospital Xeral de Vigo, Vigo (Ángeles Fernández, Patricia Fariñas), Hospital Vall d’Hebron, Barcelona (Pere Barba), Hospital Fuenlabrada, Madrid (Pilar Bravo), Hospital Parc Taulí, Sabadell (Sonia Piernas), Hospital Marqués de Valdecilla, Santander (Mercedes Colorado, Arancha Bermúdez), Hospital Lozano Blesa, Zaragoza (Maria Teresa Olave), Hospital Miguel Servet, Zaragoza (Ana Carboné), Hospital de Galdakao, Galdakao (Koldo Atutxa Aresti), Hospital Universitario de Canarias, Santa Cruz de Tenerife (Beatriz Soria, Marta Fernández, Cornelia Stoica), Institut Català d’Oncologia-Hospital Duran i Reynals, L’Hospitalet de Llobregat (Josep Sarrá), and Hospital Son Llàtzer, Palma de Mallorca (Antònia Cladera).

Potential conflict of interest:

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