1. ¹Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
2. ²Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA
3. ³Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
4. ⁴Department of Pharmaceutical Sciences St Jude Children's Research Hospital, Memphis, TN, USA

Correspondence: Dr S Jeha, Department of Oncology, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA. E-mail: sima.jeha@stjude.org

Received 15 July 2008; Revised 3 January 2009; Accepted 16 January 2009; Published online 12 March 2009.

Abstract

To evaluate the impact of contemporary therapy on the clinical outcome of children with pre-B acute lymphoblastic leukemia (ALL) and the t(1;19)/TCF3/PBX1, we analyzed 735 patients with B-cell precursor ALL treated in four successive protocols at St Jude Children's Research Hospital. The 41 patients with the t(1;19) had a comparable event-free survival to that of the 694 patients with other B-cell precursor ALL (P=0.63; 84.27.1% (s.e.) vs 84.01.8% at 5 years). However, patients with the t(1;19) had a lower cumulative incidence of any hematological relapse (P=0.06; 0 vs 8.31.2% at 5 years) but a significantly higher incidence of central nervous system (CNS) relapse (P<0.001; 9.05.1% vs 1.00.4% at 5 years). In a multivariate analysis, the t(1;19) was an independent risk factor for isolated CNS relapse. These data suggest that with contemporary treatment, patients with the t(1;19) and TCF3/PBX1 fusion have a favorable overall outcome but increased risk of CNS relapse.