Caligiuri and his colleagues examined 98 patients diagnosed with AML but who had normal chromosomes. In 11 of these patients, a closer examination showed that a short segment of the ALL1 gene had been duplicated and spliced back into the gene. In every case with these patients, their prognosis was more serious than that of patients lacking this defect.
Patients with the defect remained in remission from the disease just over seven months while those without the defect maintained remission for nearly two years. The survival time for patients in the study who had the defect was just under 14 months while patients without the defect had an average survival of 20 months.
“This means that about 5 percent of patients with AML have this defect and need to be treated quickly and aggressively,” Caligiuri said, adding that patients with the defect probably should undergo an allogenic bone marrow transplant while in their first remission of the disease if that option is a possibility.
The researchers are now beginning a larger, more comprehensive prospective study intended to validate their retrospective study. Next, they will test the effectiveness of aggressive therapy in patients with the ALL1 defect. Caligiuri suggests that a screening test for the defect, now available at Ohio State, should be widely available this year.
The international collaboration was funded by the Leukemia Society of America, the Lady Tata Memorial Fund, the Cancer Society of Finland and the Coleman Leukemia Research Fund.
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Contact: Michael Caligiuri
Caligiuri-1@medctr.osu.edu
(614) 293-7521
Ohio State University
28-Jan-1998