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Abstract

IKAROS Gene Deleted B-Cell Acute Lymphoblastic Leukemia in Mexican Mestizos: Observations in Seven Patients and a Short Review of the Literature

VOLUME 68 - NUMBER 4 / July - August (Original articles)

Guillermo J. Ruiz-Delgado, Centro de Hematología y Medicina Interna de Puebla, Clínica Ruiz, Puebla, Puebla, Mexico
Yahveth Cantero-Fortiz, Centro de Hematología y Medicina Interna de Puebla, Clínica Ruiz, Puebla, Pue.; Universidad de las Américas Puebla, Puebla, Pue., Mexico
Andrés León-Peña, Centro de Hematología y Medicina Interna de Puebla, Clínica Ruiz, Puebla, Pue.; Mexico
Mónica León-González, Centro de Hematología y Medicina Interna de Puebla, Clínica Ruiz, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico
Ana Karen Núñez-Cortés, Centro de Hematología y Medicina Interna de Puebla, Clínica Ruiz; Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
Guillermo J. Ruiz-Argüelles, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla; Faculty of Medicine, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico

Background: In B-cell acute lymphoblastic leukemia, one of the most frequent cytogenetic alterations is the presence of the Philadelphia chromosome. Recently, newly identified genetic alterations have been studied, among them the IKZF1 deletion. IKZF1 encodes IKAROS, a zinc finger protein that plays an important role in hematopoiesis involving the regulation process of adhesion, cellular migration, and as a tumor suppressor. Objective: We aimed to study the impact of IKAROS deletion in the evolution and prognosis of B-cell acute lymphoblastic leukemia. Materials and Methods: At a single center we prospectively studied patients diagnosed with B-cell acute lymphoblastic leukemia and screened for IKZF1 deletion using the multiplex ligation-dependent probe amplification method. We did a descriptive analysis of patients positive for the IKZF1 deletion to determine its impact on the evolution of the disease and survival rate. Results: Between 2010 and 2015, 16 Mexican mestizo patients with B-cell acute lymphoblastic leukemia were prospectively screened for IKZF1 deletion; seven (43%) were positive and were included for further analysis. The age range of patients was 13-60 years; six were males and one female. All cases had type B acute lymphoblastic leukemia. Of the seven patients, two died, three were lost to follow-up, and two continue in complete remission with treatment. Results are worse than those in a group of patients with non-mutated IKAROS B-cell acute lymphoblastic leukemia previously studied in our center. Conclusions: Although this is a small sample, the presence of IKAROS deletion in acute lymphoblastic leukemia patients could represent a poor-prognosis marker and was probably related to therapy failure. It is also possible that this variant of leukemia may be more prevalent in Mexico. More studies are needed to define the role of IKZF1 deletion in acute lymphoblastic leukemia and the real prevalence of the disease in different populations.

Keywords: B-cell acute lymphoblastic leukemia. IKAROS. IKZF1.

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