Adult precursor-B acute lymphoblastic leukemia with translocations involving chromosome band 19p13 is associated with poor prognosis

Cytogenetic translocations involving chromosome band 19p13, the site of the E2A gene, have previously been reported in pediatric acute lymphoblastic l eukemias (ALL) in association with a precursor-B cell immunophenotype and p oor prognosis. We studied the frequency, pathologic findings, and clinical course of adults with leukemia with 19p13 translocations. Six patients with t(1;19) (q23;p13) and one patient with t(17;19)(q21;p13), all with ALL, we re identified over an 8-year period from among 183 adult ALL patients (2.7% ); t(1;19) was observed in 2.2% and t(17;19) in 0.5% of these patients. The seven patients (four females and three males) ranged from 18 to 59 years o f age (median 33). All cases had a precursor-B cell immunophenotype, and a distinctive expression of surface markers (CD10, CD19, TdT, and HLA-Dr posi tive, usually negative for CD20, CD34, and negative for myeloid-associated antigens CD13, CD14, and CD33). The blast cells in one case expressed CD15. All patients tr ere treated with combination chemotherapy and three patien ts received allogeneic bone marrow transplantation. All patients had early (range 6-20 months) relapses, and died due to progressive disease 7-29 mont hs after diagnosis. Similar to pediatric patients, adults with 19p13 leukem ias usually do not respond to intensive therapy and have short survival. Th e poor prognosis of this group of adult ALL patients highlights the importa nce of detecting 19p13 translocations by cytogenetic analysis or molecular studies. (C) Elsevier Science Inc., 1999. All rights reserved.