Different outcome of T cell acute lymphoblastic leukemia with ă translocation t(11;14) treated in two consecutive children leukemia ă group EORTC trials

Acute lymphoblastic leukemia of T cell lineage (T-ALL) is an aggressive ă malignant disease which accounts for 15 % of childhood ALL. T(11;14) is ă the more frequent chromosomal abnormality in childhood T-ALL, but its ă prognostic value remained controversial. Our aim was to analyze the ă outcome of childhood T-ALL with t(11;14) to know if the presence of this ă translocation is associated with a poor prognosis. We conducted a ă retrospective study from a series of 20 patients with t(11;14), treated ă in two consecutive trials from the European Organization for Research ă and Treatment of Cancer Children Leukemia Group over a 19-year period ă from 1989 to 2008. There were no significant differences between the 2 ă consecutive groups of patients with t(11;14) regarding the clinical and ă biological features at diagnosis. Among 19 patients who reached complete ă remission, 9 patients relapsed. We noticed 7 deaths all relapse- or ă failure-related. In the 58881 study, a presence of t(11;14) was ă associated with a poor outcome with an event-free survival at 5 years at ă 22.2 % versus 65.1 % for the non-t(11;14) T-ALL (p = 0.0004). In the ă more recent protocol, the outcome of T-ALL with t(11;14) reached that of ă non-t(11;14) T-ALL with an event-free survival at 5 years at 65.5 versus ă 74.9 % (p = 0.93). The presence of t(11;14) appeared as a poor ă prognostic feature in the 58881 trial whereas this abnormality no longer ă affected the outcome in the 58951 study. This difference is probably ă explained by the more intensive chemotherapy in the latest trial.