Josip Konja

Intensive Chemotherapy for Childhood Acute Lymphoblastic Leukemia: Results of the Randomized Intercontinental Trial ALL IC-BFM 2002

PURPOSE From 2002 to 2007, the International Berlin-Frankfurt-Münster Study Group conducted a prospective randomized clinical trial (ALL IC-BFM 2002) for the management of childhood acute lymphoblastic leukemia (ALL) in 15 countries on three continents. The aim of this trial was to explore the impact of differential delayed intensification (DI) on outcome in all risk groups. PATIENTS AND METHODS For this trial, 5,060 eligible patients were divided into three risk groups according to age, WBC, early treatment response, and unfavorable genetic aberrations. DI was randomized as follows: standard risk (SR), two 4-week intensive elements (protocol III) versus one 7-week protocol II; intermediate risk (IR), protocol III × 3 versus protocol II × 1; high risk (HR), protocol III × 3 versus either protocol II × 2 (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP] option), or 3 HR blocks plus single protocol II (Berlin-Frankfurt-Münster [BFM] option). RESULTS At 5 years, the probabilities of event-free survival and survival were 74% (± 1%) and 82% (± 1%) for all 5,060 eligible patients, 81% and 90% for the SR (n = 1,564), 75% and 83% for the IR (n = 2,650), and 55% and 62% for the HR (n = 846) groups, respectively. No improvement was accomplished by more intense and/or prolonged DI. CONCLUSION The ALL IC-BFM 2002 trial is a good example of international collaboration in pediatric oncology. A wide platform of countries able to run randomized studies in ALL has been established. Although the alternative DI did not improve outcome compared with standard treatment and the overall results are worse than those achieved by longer established leukemia groups, the national results have generally improved.

Cytogenetic analysis in children with acute nonlymphocytic leukemia

In this work we present the results of cytogenetic analysis of the malignant cells in 27 children with acute nonlymphocytic leukemia (ANLL). The aim of our investigations was to determine the frequency and types of chromosome aberrations in our population of children with ANLL. Successful cytogenetic analysis was carried out in 24 (89%) patients. Aberrant karyotypes of malignant cells were established in 58% of the cases. The most frequent chromosomal abnormality was t(8;21), identified in 5 (20.8%) patients, i.e., 4 of 10 M2-ANLL. Aberration frequency of chromosome 11 was 16.6% and was identified in 3 of 8 M5-ANLL. Trisomy 8 and monosomy 7 were identified in one patient each with M3 and M2-ANLL, respectively. del(13), a rare chromosome aberration in hemoblastoses, was found in a child with M1,t(8;21) and the loss of chromosome Y. Translocation t(1;11;21) with a break in regions 1q23, 11q23, and 21q22, is unusual and was identified in a boy with M2-ANLL; it can be considered as a variant form of the t(8;21).

Variability of chromosomes 1, 9, and 16 in children with malignant diseases

Heterochromatic segments of chromosomes #1, #9, and #16 were analyzed in 38 children with malignant disease and 42 healthy persons. The analysis was carried out on C-banded metaphases obtained by peripheral blood culture. Using a quantitative method of analysis, an association was established between C-segment length of chromosome #9 and malignant disease in children. A disturbed quantitative relation of C-heterochromatin of chromosomes #1, #9, and #16 was also found in the group of children with malignant disease.

Marker chromosome 1q+ in acute lymphocytic leukemia☆

This paper presents the results of a cytogenetic analysis on a patient with acute lymphocytic leukemia (ALL) type L2 according to the FAB classification. Of the metaphases examined, 69.3% belong to the aberrant clone of pseudodiploid karyotype. Marker chromosome 14q+ has been identified in all the cells of the clone. Duplication was found in 30% of the metaphases, and in 15% triplication of the proximal segment of the long arm of chromosome #1 (q11-q21). In one metaphase the long arm of chromosome #1 is made up of segment q11-q21 four times repeated. Aberrations of chromosome #1 support the idea that heterochromatic region may be related to the higher degree of the cell malignity.

Heterochromatic variability in children with acute lymphoblastic leukemia

An analysis of the C-segment variability of chromosomes 1, 9, and 16 was carried out in 38 children with ALL, and 90 control subjects. When studying location variants, no differences were found between group of patients and the normal controls. A larger quantity of structural heterochromatin was, however, observed on chromosomes 1, 9, and 16, and a higher frequency of homologous chromosomes heteromorphism in children with ALL when compared with the control group.

Premature chromosome condensation in children with acute lymphocytic leukemia (L1) and malignant histiocytosis

In this study we report the observation of premature chromosome condensation (PCC) in two children with acute lymphocytic leukemia L1 and one child with malignant histiocytosis. Cytogenetic analysis was performed on peripheral blood or bone marrow cells cultivated for 24 hours without mitogen. In all three reported cases the modal karyotype was normal, while 12.9%, 5.5%, and 5% of spreads with PCC was observed, respectively.

Heterochromatic segment length of Y chromosome in 55 boys with malignant diseases

By investigating heterochromatic segment variability in a group of boys with malignant disease a significantly greater value of the Yc:F index in relation to the control subjects was established.

Jumping translocations involving 11q in a non-hodgkin lymphoma

This paper presents the results of a cytogenetic analysis in an 11-year-old boy with non-Hodgkin lymphoma. The investigation was performed on slides obtained from short-term culture of lymph node cells. The analyses revealed an abnormal clone with loss of Y, gain of an X chromosome, t(3;22), trisomy 11, and three cytogenetically-related subclones with jumping translocations involving 11q13 as the common breakpoint region. This region is an unusual site of chromosome breakage in jumping translocations, and has not been reported thus far. Contrary to most published reports, the jumping translocation in our patient is associated with long survival.

Chromosomal analysis of two neuroblastomas

We report the results of cytogenetic analysis in two children with neuroblastoma. The analysis was performed on slides obtained from a 24-hour bone marrow (BM) culture or by a direct method of the primary tumor tissue. The structural and numeric karyotype aberrations were established, including structural aberrations of chromosome 1. The finding of i(1q) and t(1;5)(p22;q13) is of interest because these chromosome aberrations are rare in this type of disease.

Cytogenetic analysis of a child with malignant histocytosis

This report presents the results of cytogenetic analysis of a child with malignant histiocytosis. The analysis was carried out on slides obtained following short-term cultures of peripheral blood cells. The malignant cells had a deletion of the long arm of chromosome #7, 46,XX,del(7)(q22).