2022 Fiscal Year Final Research Report
Multilateral prognostic factor analysis for Ph+ALL in the era of TKI
| Project/Area Number |
20K08730
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 54010:Hematology and medical oncology-related
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| Research Institution | Nagoya University |
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Principal Investigator |
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| Project Period (FY) |
2020-04-01 – 2023-03-31
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| Keywords | フィラデルフィア染色体陽性急性リンパ性白血病 / チロシンキナーゼ阻害剤 / 予後因子 / 付加的染色体異常 / +der(22)t(9;22) / 複雑核型 |
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| Outline of Final Research Achievements |
Additional chromosomal abnormalities other than the Philadelphia chromosome were found in 63.6% of 206 cases of de novo Ph+ALL. The most frequent structural abnormality was +der(22)t(9;22). Among the 43 cases with +der(22)t(9;22), 67.4% had a complex karyotype with three or more chromosomal aberrations. Coexistence of +der(22)t(9;22) and complex karyotype was associated with significantly poorer survival and shorter time to recurrence. In multivariate analysis, +der(22)t(9;22) alone or complex karyotype alone were not significant factors, but coexistence of +der(22)t(9;22) and complex karyotype was a significant risk factor for survival. This study demonstrated that the coexistence of +der(22)t(9;22) and complex karyotype was a significant prognostic factor in Ph+ALL.
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| Free Research Field |
フィラデルフィア染色体陽性急性リンパ性白血病
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| Academic Significance and Societal Importance of the Research Achievements |
Ph+ALLにおいて+der(22)t(9;22)と複雑核型の併存が予後不良因子であることを明らかとした。Ph＋ALLでは微小残存病変など治療反応性が予後因子として重要視されてきたが、染色体異常という白血病の本質的な部分でも予後を層別化できることが示された。これは、Ph＋ALLの治療の層別化につながる重要な意味を持つ。予後不良な群では同種移植を含む治療の強化により治療成績の改善を目指す一方、予後良好群では、治療強度を弱め、治療成績を維持したまま治療関連毒性を減らすことに結びつく。予後因子を明確化していくことで、個々の患者の病態に合わせた過不足ない治療選択を行うことが可能となる。
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