Program: Oral and Poster Abstracts
Session: 602. Disordered Gene Expression in Hematologic Malignancy, including Disordered Epigenetic Regulation: Poster II
Purpose:Many studies found that deletion of CDKN2 was associated with poor prognosis in ALL,and CDKN2 deletion also as a frequent cytogenetic aberration in Ph+ ALL patients. Here we study about the prognostic significance of the CDKN2 in Ph+ ALL in TKIs era.
Patients and Methods: To explore the frequency and size of alterations affecting this locus in adult BCR-ABL1–positive ALL and to investigate their prognostic value, 135 patients (98 denovo and 37 relapsed cases) were analyzed by Paired diagnosis–relapse samples were interphase fluorescence in situ hybridization(I-FISH).
Results:The prevalence of CDKN2 deletions in all study population was 27.4%(37/135). There is no difference between patients with CDKN2 deletion and wild-type patients in sex, age, white blood cells(WBC) count, BM blast percentage,and induction complete remission(CR) rate. Compared with patients with wild-type CDKN2, the patients with CDKN2 deletion had higher rates of hepatosplenomegaly, CD20 expression (p<0.05). Deletions of CDKN2 were significantly associated with poor outcomes including decreased overall survival (OS) (P<0.001), lower disease free-survival (DFS) (P<0.001), and increased cumulative incidence of relapse (P=0.003). In case of 37 patients with CDKN2 deletion,20 patients treated with chemotherapy and Dasatinib followed by allogeneic hematopoietic stem cell transplantation(Allo-HSCT),and another 13 patients treated with chemotherapy and Imatinb followed by Allo-HSCT,there were no difference associated with OS(P=0.813) and DFS(p=0.513) between the above groups.
Conclusions:Deletion of CDKN2 by I-FISH is a frequent event in Ph–positive ALL, and frequently acquired during leukemia progression and are a poor prognostic marker of long-term outcomes even though treated by adding dasatinib. We also found CDKN2 deletion patients had higher CD20 expression, this group patients may be benefit from rituximab.
Disclosures: No relevant conflicts of interest to declare.
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