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High-Risk Leukemia Subtype Becomes More Common With Age, Genomic Analysis Reveals

By Kamal Nayan | Update Date: Sep 11, 2014 09:10 AM EDT

More than 25 percent of young adults with the most common form of acute lymphoblastic leukemia (ALL) have a high-risk subtype with a poor prognosis, according to a new study. 

The findings of the study suggested that those adults may benefit from drugs widely used to treat other types of leukemia that are more common in adults. 

ALL is the most common childhood cancer. The study focused on a subtype of ALL known as Philadelphia chromosome-like ALL (Ph-like ALL). 

The analysis found the prevalence of Ph-like ALL increases with age and that the subtype is associated with poor survival. 

"We showed that Ph-like ALL is a common disease that spans the age spectrum, and we identified new genomic alterations that converge on a handful of signaling pathways that are vulnerable to treatment with tyrosine kinase inhibitors," said corresponding author Charles Mullighan, M.D., MBBS(Hons), a member of the St. Jude Department of Pathology, in the press release. "The findings lead the way for clinical trials that could help to transform the outlook for patients regardless of age."

"The findings are tremendously exciting and pave the way for clinical trials testing TKIs plus chemotherapy in subsets of children and adolescents with ALL," added another  corresponding author Stephen P. Hunger, M.D., professor of pediatrics at the University of Colorado School of Medicine and the chair of the COG ALL Committee. 

Investigators from the COG and St. Jude have developed plans to test more than 800 children annually enrolled in COG ALL clinical trials to identify those who might benefit from this treatment approach. That is the clinical trial expected to open this year or early in 2015, according to the press release.

The study has been published in The New England Journal of Medicine.

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