In acute leukemia, chromosomal alterations serve as diagnostic and prognostic markers, detectable via various techniques. Our institution previously studied chromosomal abnormalities over two periods of time, noting any differences. This study investigated the frequency of these abnormalities and clinical trends in acute leukemia in Korea across three time periods.

We reviewed data from 1,787 acute leukemia patients (319 children, 1,468 adults) diagnosed between 2006 and 2020. Conventional cytogenetics, fluorescence in situ hybridization (FISH), and multiplex RT-PCR were used for analysis. Patients were grouped into three periods: 2006-2009 (I), 2010-2015 (II), and 2016-2020 (III).

Chromosomal aberrations were identified in 92% of patients using conventional cytogenetics, with PML::RARA being the most frequent. Age-specific patterns showed significant differences in fusion genes between children and adults, with some abnormalities detectable only using specific methods. In adult patients, a significant increase in the median age receiving intensive chemotherapy was observed (median years: 48 vs. 53 vs. 60 in periods I, II, and III, respectively, P <0.001). An improvement in overall survival during period III was particularly evident in patients over 50 years old (P=0.003).

Over the 15-year period, chromosomal aberrations showed minimal changes, with consistent common fusion transcripts. In children, acute lymphoblastic leukemia (ALL) is more prevalent, with significant ETV6::RUNX1 and RUNX1::RUNX1T1 aberrations. In adults, the incidence has increased, with PML::RARA remaining common. Clinically, advances in transplantation and supportive care have allowed for increased intensive chemotherapy administration to older patients, improving survival rates.

Disclosures

No relevant conflicts of interest to declare.

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2024
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