ALL: Ph-like subtype relatively prevalent, carries poorer prognosis

  • Owattanapanich W, et al.
  • Clinical Lymphoma, Myeloma and Leukemia
  • 16 Aug 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Philadelphia-like acute lymphoblastic leukemia (Ph-like ALL) is quite prevalent and associated with inferior survival vs other forms of ALL.
  • Survival is comparable vs Philadelphia-positive (Ph+) ALL.

Why this matters

  • Ph-like ALL is a relatively new genetic subtype of ALL, first reported in 2009.

Study design

  • Systematic review and meta-analysis to investigate the prevalence of, and outcomes in, Ph-like ALL.
  • A search of MEDLINE and EMBASE yielded 15 studies comprising 11,040 patients with ALL and 1546 patients with Ph-like ALL.
  • Funding: None disclosed.

Key results

  • 15.4% (95% CI, 12.3%-19.1%) pooled prevalence of Ph-like ALL among studied ALL patients.
  • Peak prevalence of Ph-like ALL was in the following age groups:
    • Age 11-20 years: 26.2% (95% CI, 23.6%-28.9%).
    • Age 21-40 years: 25.8% (95% CI, 22.1%-29.8%).
  • 42.8% (95% CI, 23.9%-64.1%) pooled 5-year OS.
  • Patients with Ph-like ALL had significantly lower chance of 5-year survival vs other B-cell ALL patients: pooled OR, 0.35 (95% CI, 0.25-0.50); P<.00001.>
  • Patients with Ph-like ALL had comparable chance of 5-year survival vs Ph+ ALL patients: pooled OR, 0.72 (95% CI, 0.26-2.02); P=.53.

Limitations

  • Retrospective data.