Biologic features and treatment outcome of secondary acute lymphoblastic leukemia--a review of 101 cases

Abstract

Background: Secondary acute lymphoblastic leukemia (sALL) is a rare disease and its biologic features are not well characterized.

Patients and methods: We describe a cohort of seven patients and discuss 94 additional cases from the literature for whom biological parameters were described. Cases with incomplete data were excluded.

Results: Hodgkin's disease (HD) was more common in the 18-59 age group while breast and prostate cancers were prevalent only in the >or=18-year-old patients. The time interval to develop sALL was similar among all age groups but was significantly longer for HD and neuroblastoma primary diagnoses and sALL with complex karyotype. T-cell immunophenotype was more common in the <18 age group. Complete remission was infrequent in the >or=60 age group. The overall survival was poor for all sALL regardless of age, primary diagnoses, cytogenetic subgroups, or immunophenotype. Allogeneic transplantation most probably represents the only chance of cure.

Conclusion: Better identification of prognostic factors to prevent the occurrence of sALL is indicated.

Figure 1.

The relationship between median time interval and (A) primary diagnosis and (B) karyotype in secondary acute lymphoblastic leukemia. The numbers on the columns represent number of patients per cohort. The P value in panel A represents an overall P value; for individual P values please refer to the text. AML, acute myeloid leukemia; HD, Hodgkin's disease.