Landscape of additional chromosomal abnormalities in philadelphia chromosome positive acute lymphoblastic leukemia: 5year experience of a regional cancer center in south east Asia

Background: Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL) is an aggressive disease, which differs from chronic myeloid leukemia in lymphoid blast crisis at both chromosomal and molecular level. The current study aims to study additional chromosomal abnormalities (ACAs) in Ph+ALL, with review on its prognostic implications. Materials and Methods: This is retrospective single group exploratory study, from 2014 to 2019. Cytogenetic information of 74 cases of Ph+ALL and their clinical information were obtained from the departmental records and case files. Cytogenetic analysis of samples was done in accordance with standard laboratory protocol. Results: Thirty out of 74 patients showed ACAs (40.5%). The median age of patients was 21years. ACAs were more frequent in females than in males up to 40years of age and reverse was true in older patients. Most frequent abnormalities observed were extra Ph, del(9p), add(19p), del(6q) and dic(9;12). Limited follow-up data for patients with extra Ph showed complete remission at median survival of 15 months and poor prognosis in an elderly patient with dic(9;12) as additional abnormality. Conclusion: The frequency and pattern of ACAs in our cohort of Ph+ALL patients were similar to standard available literature, with few exceptions. Long-term follow-up studies are recommended to analyze the prognostic significance of these ACAs in Ph+ALL.