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Correlation between deletion of the CDKN2 gene and tyrosine kinase inhibitor resistance in adult Philadelphia chromosome-positive acute lymphoblastic leukemia.

Xu N, Li YL, Li X, Zhou X, Cao R, Li H, Li L, Lu ZY, Huang JX, Fan ZP, Huang F, Zhou HS, Zhang S, Liu Z, Zhu HQ, Liu QF, Liu XL - J Hematol Oncol (2016)

Bottom Line: Results showed that no difference occurred between patients with CDKN2 deletion (44/135) and wild-type patients in sex, age, and complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs).However, CDKN2 deletion carriers demonstrated higher white blood cell (WBC) count, enhanced rates of hepatosplenomegaly (P = 0.006), and upregulation of CD20 expression (P = 0.001).In the case of 44 patients who presented with CDKN2 deletion, 18 patients were treated with dasatinib treatment, and another 26 patients were treated with imatinib therapy, and our study found that there were no differences associated with OS (P = 0.508) and DFS (P = 0.555) between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

ABSTRACT

Background: Frequency relapses are common in Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL) following tyrosine kinase inhibitors (TKIs). CDKN2A/B is believed to contribute to this chemotherapy resistance.

Methods: To further investigate the association between CDKN2 status and TKI resistance, the prevalence of CDKN2 deletions and its correlation with a variety of clinical features was assessed in 135 Ph-positive ALL patients using interphase fluorescence in situ hybridization (I-FISH).

Results: Results showed that no difference occurred between patients with CDKN2 deletion (44/135) and wild-type patients in sex, age, and complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs). However, CDKN2 deletion carriers demonstrated higher white blood cell (WBC) count, enhanced rates of hepatosplenomegaly (P = 0.006), and upregulation of CD20 expression (P = 0.001). Moreover, deletions of CDKN2 resulted in lower rates of complete molecular response (undetectable BCR/ABL), increased cumulative incidence of relapse, short overall survival (OS), and disease-free survival (DFS) time (P < 0.05) even though these patients received chemotherapy plus TKIs followed by allogenic hematopoietic stem cell transplantation (Allo-HSCT). In the case of 44 patients who presented with CDKN2 deletion, 18 patients were treated with dasatinib treatment, and another 26 patients were treated with imatinib therapy, and our study found that there were no differences associated with OS (P = 0.508) and DFS (P = 0.555) between the two groups.

Conclusions: CDKN2 deletion is frequently acquired during Ph-positive ALL progression and serves as a poor prognostic marker of long-term outcome in Ph-positive ALL patients with CDKN2 deletion even after the second-generation tyrosine kinase inhibitor treatment.

No MeSH data available.


Related in: MedlinePlus

Overall survival comparison among Ph-positive patients. Kaplan–Meier Curve demonstrated significantly a shorter survival time in CDKN2 wild-type patients than in CDKN2 deletion patients (P = 0.004)
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Fig2: Overall survival comparison among Ph-positive patients. Kaplan–Meier Curve demonstrated significantly a shorter survival time in CDKN2 wild-type patients than in CDKN2 deletion patients (P = 0.004)

Mentions: The median follow-up for 135 adults was 25.6 months (1.2–78.9 months). The relapse rate in the CDKN2 deletion subgroup was higher than in the subgroup with no CDKN2 deletion (59.1 versus 35.2 %, P = 0.008) (Table 1). OS and DFS curves are shown in Figs. 2 and 3. The estimated 2-year overall survival and 2-year disease-free survival rates by the Kaplan–Meier method for patients with CDKN2 wild-type were 65.5 and 51.1 %, respectively, and for patients with CDKN2 deletion were 35.2 and 23.3 %, respectively. The results revealed that CDKN2 deletion was associated with a significant inferior OS (P = 0.004) and DFS (P = 0.005).Fig. 2


Correlation between deletion of the CDKN2 gene and tyrosine kinase inhibitor resistance in adult Philadelphia chromosome-positive acute lymphoblastic leukemia.

Xu N, Li YL, Li X, Zhou X, Cao R, Li H, Li L, Lu ZY, Huang JX, Fan ZP, Huang F, Zhou HS, Zhang S, Liu Z, Zhu HQ, Liu QF, Liu XL - J Hematol Oncol (2016)

Overall survival comparison among Ph-positive patients. Kaplan–Meier Curve demonstrated significantly a shorter survival time in CDKN2 wild-type patients than in CDKN2 deletion patients (P = 0.004)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4836197&req=5

Fig2: Overall survival comparison among Ph-positive patients. Kaplan–Meier Curve demonstrated significantly a shorter survival time in CDKN2 wild-type patients than in CDKN2 deletion patients (P = 0.004)
Mentions: The median follow-up for 135 adults was 25.6 months (1.2–78.9 months). The relapse rate in the CDKN2 deletion subgroup was higher than in the subgroup with no CDKN2 deletion (59.1 versus 35.2 %, P = 0.008) (Table 1). OS and DFS curves are shown in Figs. 2 and 3. The estimated 2-year overall survival and 2-year disease-free survival rates by the Kaplan–Meier method for patients with CDKN2 wild-type were 65.5 and 51.1 %, respectively, and for patients with CDKN2 deletion were 35.2 and 23.3 %, respectively. The results revealed that CDKN2 deletion was associated with a significant inferior OS (P = 0.004) and DFS (P = 0.005).Fig. 2

Bottom Line: Results showed that no difference occurred between patients with CDKN2 deletion (44/135) and wild-type patients in sex, age, and complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs).However, CDKN2 deletion carriers demonstrated higher white blood cell (WBC) count, enhanced rates of hepatosplenomegaly (P = 0.006), and upregulation of CD20 expression (P = 0.001).In the case of 44 patients who presented with CDKN2 deletion, 18 patients were treated with dasatinib treatment, and another 26 patients were treated with imatinib therapy, and our study found that there were no differences associated with OS (P = 0.508) and DFS (P = 0.555) between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

ABSTRACT

Background: Frequency relapses are common in Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL) following tyrosine kinase inhibitors (TKIs). CDKN2A/B is believed to contribute to this chemotherapy resistance.

Methods: To further investigate the association between CDKN2 status and TKI resistance, the prevalence of CDKN2 deletions and its correlation with a variety of clinical features was assessed in 135 Ph-positive ALL patients using interphase fluorescence in situ hybridization (I-FISH).

Results: Results showed that no difference occurred between patients with CDKN2 deletion (44/135) and wild-type patients in sex, age, and complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs). However, CDKN2 deletion carriers demonstrated higher white blood cell (WBC) count, enhanced rates of hepatosplenomegaly (P = 0.006), and upregulation of CD20 expression (P = 0.001). Moreover, deletions of CDKN2 resulted in lower rates of complete molecular response (undetectable BCR/ABL), increased cumulative incidence of relapse, short overall survival (OS), and disease-free survival (DFS) time (P < 0.05) even though these patients received chemotherapy plus TKIs followed by allogenic hematopoietic stem cell transplantation (Allo-HSCT). In the case of 44 patients who presented with CDKN2 deletion, 18 patients were treated with dasatinib treatment, and another 26 patients were treated with imatinib therapy, and our study found that there were no differences associated with OS (P = 0.508) and DFS (P = 0.555) between the two groups.

Conclusions: CDKN2 deletion is frequently acquired during Ph-positive ALL progression and serves as a poor prognostic marker of long-term outcome in Ph-positive ALL patients with CDKN2 deletion even after the second-generation tyrosine kinase inhibitor treatment.

No MeSH data available.


Related in: MedlinePlus