Prognostic significance of cytogenetic abnormalities in T-cell prolymphocytic leukemia

Zhihong Hu, L. Jeffrey Medeiros, Lianghua Fang, Yi Sun, Zhenya Tang, Guilin Tang, Tsieh Sun, Andres E. Quesada, Shimin Hu, Sa A. Wang, Lin Pei, Xinyan Lu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


T-cell prolymphocytic leukemia (T-PLL) is an aggressive mature T-cell neoplasm. The most common cytogenetic abnormality associated with T-PLL is inv(14)(q11.2q32) involving TCL1, but other abnormalities also have been reported. In this study, we correlated cytogenetic abnormalities with clinical outcome in 97 T-PLL patients, including 66 men and 31 women with a median age of 63 years (range, 34-81). Twenty-seven patients had a normal karyotype (NK), one had two chromosomal aberrations, and 69 had a complex karyotype (CK). Patients with a CK had poorer overall survival (OS) than patients with a NK (P =.0016). In the CK group, the most common aberrations involved 14q (n = 45) and 8q (n = 38). Additional deletions of chromosomes 17p, 11q, 6q, 12p, 13q were observed frequently. No individual cytogenetic abnormality impacted OS. Patients with ≥5 aberrations had an OS of 11 months versus 22 months in patients with <5 aberrations (P = 0.0132). Fluorescence in situ hybridization for TCL1 successfully performed in 27 cases showed rearrangement in 8/10 (80%) NK versus 16/17 (94%) CK cases. OS of patients with TCL1 rearrangement and/or 14q aberrations was not significantly different from patients without TCL1 rearrangement and 14q aberrations (P =.3467). Patients with refractory disease showed worse OS in both the NK and CK groups (P =.0014 and P <.0001, respectively), compared with patients who achieved remission but then relapsed. Stem cell transplantation did not appear to improve OS regardless of karyotype complexity. In conclusion, patients with T-PLL often have a CK which is a poor prognostic factor, particularly in patients with ≥5 cytogenetic aberrations.

Original languageEnglish (US)
Pages (from-to)441-447
Number of pages7
JournalAmerican Journal of Hematology
Issue number5
StatePublished - May 1 2017

ASJC Scopus subject areas

  • Hematology


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