Prognostic significance of IKZF1 gene deletions in patients with B-cell acute lymphoblastic leukemia.
10.3760/cma.j.issn.0253-2727.2022.03.009
- Author:
Bing Qing TANG
1
;
Zi Hong CAI
1
;
Dai Nan LIN
2
;
Zhi Xiang WANG
1
;
Xiao Jie LIANG
1
;
Zhi Ping FAN
1
;
Fen HUANG
1
;
Qi Fa LIU
1
;
Hong Sheng ZHOU
1
Author Information
1. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
2. Department of Hematology, Guangzhou Twelfth People's Hospital, Guangzhou 510515, China.
- Publication Type:Journal Article
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
Gene, IKZF1;
Leukemia, B-cell, acute
- MeSH:
Acute Disease;
Burkitt Lymphoma;
Child;
Gene Deletion;
Humans;
Ikaros Transcription Factor/genetics*;
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/therapy*;
Prognosis
- From:
Chinese Journal of Hematology
2022;43(3):235-240
- CountryChina
- Language:Chinese
-
Abstract:
Objective: This study aimed to investigate the prognostic significance of IKZF1 gene deletion in patients with acute B lymphoblastic leukemia (B-ALL) . Methods: The clinical data of 142 patients with B-ALL diagnosed in Nanfang Hospital between March 2016 and September 2019 were analyzed. Results: IKZF1 deletion was found in 36.0% of the 142 patients with B-ALL, whereas exon 4-7 deletion was found in 44.0% . White blood cell counts were higher in patients with the IKZF1 deletion (52.0% and 28.3% , P=0.005) ; these patients also experienced worse effects of mid-term induction therapy (40.0% and 70.7% , P<0.001) and had a higher proportion of Philadelphia chromosome-positive (52.0% and 21.7% , respectively, P<0.001) . Univariate analysis revealed that the 3-year overall survival rate (OS) and event-free survival rate (EFS) in the IKZF1 deletion group were significantly lower than the IKZF1 wild-type group [ (37.1±7.3) % vs (54.7±5.4) % , (51.8±7.9) % vs (73.9±4.7) % ; P=0.025, 0.013, respectively]. Multivariable analysis showed that harboring IKZF1 deletion was an adverse factor of EFS and OS (HR=1.744, 2.036; P=0.022, 0.020, respectively) . Furthermore, the IKZF1 deletion/chemotherapy group had significantly lower 3-year OS, EFS, and disease-free survival rates than other subgroups. In the IKZF1 deletion cohort, allo-hematopoietic stem cell transplantation (HSCT) significantly improved OS and EFS compared to non-allo-HSCT[ (67.9±10.4) % vs (31.9±11.0) % , (46.6±10.5) % vs (26.7±9.7) % ; P=0.005, 0.026, respectively]. Conclusion: Pediatric-inspired chemotherapy was unable to completely reverse the negative effect of IKZF1 deletion on prognosis. Pediatric-inspired regimen therapy combined with allo-HSCT, in contrast, significantly improved the overall prognosis of IKZF1 deletion B-ALL.
