CDKN2A deletions are associated with poor outcomes in 101 adults with T‐cell acute lymphoblastic leukemia

• Published in: American journal of hematology Vol. 96; no. 3; pp. 312 - 319
• Main Authors: Wang, Huan‐Ping, Zhou, Yi‐Le, Huang, Xin, Zhang, Yi, Qian, Jie‐Jing, Li, Jian‐Hu, Li, Xue‐Ying, Li, Chen‐Ying, Lou, Yin‐Jun, Mai, Wen‐Yuan, Meng, Hai‐Tao, Yu, Wen‐Juan, Tong, Hong‐Yan, Jin, Jie, Zhu, Hong‐Hu
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-03-2021; Wiley Subscription Services, Inc
• Subjects: Acute lymphoblastic leukemia; Adolescent; Adult; Aged; Allografts; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; China - epidemiology; Combined Modality Therapy; Cyclin-Dependent Kinase Inhibitor p16 - deficiency; DNA Mutational Analysis; DNA, Neoplasm - genetics; Female; Fluorescence in situ hybridization; Gene Deletion; Genes, p16; Hematology; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; High-Throughput Nucleotide Sequencing; Humans; In Situ Hybridization, Fluorescence; L-Lactate dehydrogenase; Lactic acid; Leukemia; Lymphatic leukemia; Male; Medical prognosis; Middle Aged; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - mortality; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prognosis; Risk groups; Transplantation; Treatment Outcome; Tumor suppressor genes; Young Adult; China
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.26069

The identification of genetic risk subgroups of T‐cell acute lymphoblastic leukemia (T‐ALL) may provide evidence for risk stratification and individualized treatment. We investigated the characteristics and prognostic value of tumor suppressor gene CDKN2A deletions in 101 patients with T‐ALL. The CDKN2A deletion was present in 23% (23/101) of T‐ALL by fluorescence in situ hybridization (FISH). The most common type of CDKN2A deletion was homozygous deletion (70%, 16/23). A lower frequency of CDKN2A deletion was found in patients with early T‐cell precursor (ETP) ALL than in patients with non‐ETP‐ALL (10.4% vs 34.0%; P = .008). Deletion of CDKN2A was significantly associated with younger age (P = .001), higher white blood cell (WBC) count (P < .001) and higher lactate dehydrogenase (LDH) level (P = .002). Patients with CDKN2A deletion had lower 2‐year overall survival (OS) and event‐free survival (EFS) rates than patients without CDKN2A deletion (2‐year OS: 18.6% ± 8.9% vs 47.4% ± 6.2%, P = .032; EFS: 16.4 ± 8.3 vs 38.6 ± 5.9%, P = .022). In multivariable analysis, CDKN2A deletion was an independent adverse prognostic factor for OS (P = .016). In conclusion, adult T‐ALL patients with CDKN2A deletion had a poor prognosis, and these patients might benefit from intensive chemotherapy or allogeneic hematopoietic stem‐cell transplantation.