Blood Journal
Leading the way in experimental and clinical research in hematology

Hyperdiploidy with 58-66 chromosomes in childhood B-acute lymphoblastic leukemia is highly curable: 58951 CLG-EORTC results

  1. Nicole Dastugue1,*,
  2. Stefan Suciu2,
  3. Geneviève Plat3,
  4. Frank Speleman4,
  5. Hélène Cavé5,
  6. Sandrine Girard6,
  7. Marleen Bakkus7,
  8. Marie Pierre Pagès6,
  9. Karima Yakouben8,
  10. Brigitte Nelken9,
  11. Anne Uyttebroeck10,
  12. Carine Gervais11,
  13. Patrick Lutz12,
  14. Manuel R. Teixeira13,
  15. Pierre Heimann14,
  16. Alice Ferster15,
  17. Pierre Rohrlich16,
  18. Marie Agnès Collonge17,
  19. Martine Munzer18,
  20. Isabelle Luquet19,
  21. Patrick Boutard20,
  22. Nicolas Sirvent21,
  23. Matthias Karrasch2,
  24. Yves Bertrand22, and
  25. Yves Benoit23
  1. 1 Hematology laboratory, Purpan Hospital, Toulouse, France;
  2. 2 EORTC Headquarters, Brussels, Belgium;
  3. 3 Department of Hematology, Children's Hospital, Toulouse, France;
  4. 4 Center for Medical Genetics, Universiteit Ziekenhuis Ghent, Belgium;
  5. 5 Department of Genetics, Assistance publique-Hopitaux de Paris, Hopital Robert Debre, Paris, France;
  6. 6 Hematology laboratory, Lyon Sud Hospital, Lyon, France;
  7. 7 Molecular Hematology laboratory, UZ Brussels, Brussels, Belgium;
  8. 8 Department of Hemato-Immunology, Robert Debre Hospital, Paris, France;
  9. 9 University Lille Nord de France and Pediatric Hematology-Unit, Centre Hospitalier Universitaire, Lille, France;
  10. 10 Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium;
  11. 11 Hematology laboratory, Hautepierre, Strasbourg, France;
  12. 12 Department of Pediatric Hematology, Hautepierre, Strasbourg, France;
  13. 13 Department of Genetics, Portuguese Oncology Institute, Porto and Biomedical Sciences Institute (ICBAS), university of Porto, Portugal;
  14. 14 Laboratory of Cytogenetics, Bordet Institute, Brussels, Belgium;
  15. 15 Department of Hemato-Oncology, Hopital Universitaire des Enfants Reine Fabiola, Brussels, Belgium;
  16. 16 Department of Pediatric Hematology-Oncology, Centre Hospitalier Universitaire, Besancon, France;
  17. 17 Department of Genetics, Centre Hospitalier Universitaire, Besancon, France;
  18. 18 Department of Pediatric Hematology-Oncology, Centre Hospitalier Universitaire, Reims, France;
  19. 19 Hematology laboratory, Centre Hospitalier Universitaire, Reims, France;
  20. 20 Department of Pediatric Hematology-Oncology, Centre Hospitalier Universitaire, Caen, France;
  21. 21 Department of Pediatric Hematology-Oncology, Centre Hospitalier Universitaire, Nice, France;
  22. 22 Department of Immuno-Hemato-Pediatrics, Hospices Civils de Lyon et Universite Claude Bernard Lyon 1, France;
  23. 23 Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
  1. * Corresponding author; email: dastugue.n{at}

Key points

  • Prognostic impact of ploidy and DNA index in children with B-ALL and hyperdiploidy higher than 50 chromosomes

  • The higher the ploidy, the better the prognosis in the 58951 EORTC-CLG study


The aim of our study was to analyze the factors contributing to heterogeneity of prognosis in patients with hyperdiploidy>50 chromosomes (HD>50), a group of B-cell precursor acute lymphoblastic leukemia with favorable outcome. The 541 HD>50 patients registered prospectively in the 58951 CLG-EORTC trial, identified by karyotype (446 patients) and by DNA index (DI) (490 patients), had a 6-year EFS of 89.0% (SE=1.5%) and a 6-year overall survival (OS) of 95.9% (SE=0.9%). The strongest prognostic factor was the modal number of chromosomes (MNC): the 6-year EFS of 51-53, 54-57 and 58-66 MNC groups were 80%, 89% and 99% respectively (P<0.0001). Ploidy assessed by DNA index (DI) was also a favorable factor, the higher the DI the better the outcome: the 6-year EFS of the three subgroups of DI <1.16/≥1.16-<1.24/≥1.24 were 83%, 90% and 95% respectively (P=0.009). All usual combinations of trisomies (chromosomes 4,10,17,18) were significant favorable factors but had lower EFS when MNC was lower than 58. In multivariate analysis, MNC remained the strongest factor. Consequently, the best indicator for excellent outcome was ploidy assessed by karyotype because patients with 58-66 chromosomes stood every chance of being cured (OS of 100% at 6-year follow-up) with less intensive therapy. NCT00003728, Registered:,

  • Submitted June 20, 2012.
  • Accepted January 3, 2013.