Prognostic Differences Between P190 and P210 BCR::ABL1 in Patients with Philadelphia-Positive B-cell Acute...

Area of Science:

• Hematology
• Oncology
• Molecular Biology

Background:

• Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is a distinct subtype.
• BCR::ABL1 oncogene fusions, specifically p190 and p210 isoforms, are key drivers in Ph+ ALL.
• Understanding isoform-specific prognostic implications is crucial for treatment stratification.

Purpose of the Study:

• To investigate whether p190 and p210 BCR::ABL1 isoforms in adult Ph+ ALL patients are associated with different survival outcomes.
• To compare prognostic factors between patients with p190 and p210 isoforms.

Main Methods:

• Retrospective multicenter study of adult patients (≥18 years) with de novo Ph+ B-cell ALL.
• Comparison of overall survival (OS), progression-free survival (PFS), and prognostic factors between p190 and p210 groups.
• Data retrieved from hospital records, including diagnosis characteristics, treatment response, relapse rates, transplantation needs, and mortality.

Main Results:

• Among 44 patients, 59.1% had the p190 isoform and 40.9% had the p210 isoform.
• Groups were comparable in diagnosis characteristics, treatment response, and molecular relapse rates.
• Two-year OS rates were 48.6% (p190) vs. 70.5% (p210); 5-year OS rates were 33.3% (p190) vs. 47.0% (p210).
• Two-year PFS rates were 38.2% (p190) vs. 65.3% (p210); 5-year PFS rates were 31.9% (p190) vs. 42.3% (p210).
• Overall mortality was 56.8%, with infection as the leading cause of death in both groups.

Conclusions:

• p190 and p210 BCR::ABL1 isoforms in adult Ph+ B-ALL patients do not appear to significantly differ in terms of prognostic parameters.
• Survival outcomes, including OS and PFS, showed no significant distinction between the p190 and p210 isoforms.
• Further research may be warranted to explore subtle differences or alternative prognostic markers in Ph+ ALL.