The frequency and prognostic impact of dic(9;20)(p13.2;q11.2) in childhood B-cell precursor acute lymphoblastic leukemia: results from the NOPHO ALL-2000 trial

V. Zachariadis, F. Gauffin, E. Kuchinskaya, M. Heyman, J. Schoumans, E. Blennow, B. Gustafsson, G. Barbany, I. Golovleva, Hans Ehrencrona, L. Cavelier, Linda Palmqvist, G. Lonnerholm, M. Nordenskjold, Bertil Johansson, E. Forestier, Agneta Nordgren

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Abstract

The dic(9;20)(p13.2;q11.2) is reported to be present in similar to 2% of childhood B-cell precursor acute lymphoblastic leukemia (BCP ALL). However, it easily escapes detection by G-banding analysis and its true prevalence is hence unknown. We performed interphase fluorescence in situ hybridization analyses-in a three-step manner-using probes for: (i) CDKN2A at 9p21, (ii) 20p and 20q subtelomeres and (iii) cen9 and cen20. Out of 1033 BCP ALLs diagnosed from 2001 to 2006, 533 were analyzed; 16% (84/533) displayed 9p21 deletions, of which 30% (25/84) had dic(9;20). Thus, dic(9;20)-positivity was found in 4.7% (25/533), making it the third most common genetic subgroup after high hyperdiploidy and t(12;21)(p13;q22). The dic(9;20) was associated with a female predominance and an age peak at 3 years; 18/25 (72%) were allocated to non-standard risk treatment at diagnosis. Including cases detected by G-banding alone, 29 dic(9;20)-positive cases were treated according to the NOPHO ALL 2000 protocol. Relapses occurred in 24% (7/29) resulting in a 5-year event-free survival of 0.69, which was significantly worse than for t(12;21) (0.87; P = 0.002) and high hyperdiploidy (0.82; P = 0.04). We conclude that dic(9;20) is twice as common as previously surmised, with many cases going undetected by G-banding analysis, and that dic(9;20) should be considered a non-standard risk abnormality. Leukemia (2011) 25, 622-628; doi:10.1038/leu.2010.318; published online 18 January 2011
Original languageEnglish
Pages (from-to)622-628
JournalLeukemia
Volume25
Issue number4
DOIs
Publication statusPublished - 2011

Subject classification (UKÄ)

  • Cancer and Oncology

Free keywords

  • * 20) * dic(9 * acute lymphoblastic leukemia* FISH

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