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Abstract
OBJECTIVE: To study the clinical characteristics, prognostic factors and therapeutic outcome of Philadelphia chromosome positive adult acute lymphoblastic leukemia (Ph+ ALL). METHODS: The clinical data of 51 cases above 18 years old diagnosed with Ph+ALL at NCI Cairo, between 2011 and 2014 were retrospectively analyzed. RESULTS: There were 51 (24.4%) - out of 209 B-ALL patients - diagnosed as Ph(+)ALL. The complete remission (CR) rate after induction therapy was 80.5%, the median DFS was 7.1 months (range 0.2 - 58.6 months) and the median OS time was 5.4 months (range; 0.1 - 68.7 months). p210 type was present in 31 cases (60.8%) while p190 type was present in 18 cases (35.3%) and both types were present in 2 cases (3.9%) with statistically significant prevalence of p210 type in males and p190 type in females (P= 0.003). Bone pain was significantly associated with p190+ve cases more than p210+ve cases (P = 0.04), while other clinical and laboratory differences between both groups were insignificant. Patients presented initially with platelet count > 100 x 109/L had a statistically significant better DFS (P= 0.001) and OS (P= 0.002) than patients presented with platelet count < 100 x 10⁹/L. Patients presented with initial hemoglobin level {u2265} 10 g/dl had statistically significant better OS (P= 0.04) than patients presented with hemoglobin level < 10 g/dl. Patients presented initially with ECOG PS = 1 had significantly better OS (P = 0.02) than patients with PS > 1. The difference in DFS and OS among patients who underwent alloHSCT and patients who continued TKI based consolidation/maintenance treatment was significantly better than patients who continued chemotherapy alone (median DFS; not reached and 16.5 vs 3.9 months and median OS; not reached and 21.5 vs 1.4 months respectively, P value < 0.001)