诊断时额外的染色体异常（ACAs）与慢性粒细胞白血病的不良预后相关。然而，ACA对于接受TKI靶向药物和异基因造血干细胞移植（HSCT）的费城染色体阳性急性淋巴细胞白血病（Ph  ALL）成年患者的预后意义尚不清楚。该研究纳入了 136 名成年 Ph   ALL 患者并进行回顾性分析，评估 ACA 对移植结果的影响。 60 例 (44%) 中观察到 ACA。在超过 5% 的病例中检测到的 ACA 被定义为主要途径，包括：der(22)、der(9)、8、-7 和复杂核型。中位随访时间为 26.4 个月。在主要途径ACA的亚组分析中，三年累积复发率（CIR）和无进展生存率（PFS）在 8组中具有统计学意义[66.7% vs.23.7%，P = 0.024； 77.8% vs. 23.7%, P = 0.0087], -7[53.8% vs. 23.7%, P = 0.035%; 61.5% vs. 32.9%，P = 0.033]，复杂核型[42.9% vs. 23.7%，P = 0.027； 47.6% vs. 23.7%] 与 t(9;22) 鞋底相比。此外，使用 der(22) 的 Ph   ALL 的 3 年 CIR 为 44%，而 t(9;22) sole 的 3 年 CIR 为 23.7%（P = 0.045）。 - 7组的3年总生存率（OS）为46.5%，与其他组相比具有统计学意义（P = 0.001）。多变量分析显示，与t(9;22) single相比， der(22)、 8、-7和复杂核型的三年CIR和PFS具有统计学意义(P < 0.05)。更重要的是，Ph  ALL with - 7与3年OS率呈负相关（P = 0.012）。因此，诊断时的 ACA 似乎对 Ph  ALL 患者的移植结果具有显着的预后影响。© 2024。作者获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

Additional chromosomal abnormalities(ACAs) at diagnosis are associated with inferior prognosis in chronic myeloid leukemia. However, the prognostic significance of ACAs in adult patients with Philadelphia Chromosome Positive acute lymphoblastic leukemia (Ph + ALL) receiving TKI-targeted drugs and allogeneic hematopoietic stem cell transplantation(HSCT) is unknown. One hundred thirty-six adult patients with Ph + ALL were included in the study and retrospectively analysed, evaluating the effect of ACAs on outcomes of transplantation. ACAs are observed in 60 cases (44%). ACAs detected in more than 5% of cases were defined as major-route and encompass: +der(22), +der(9), + 8, -7 and complex karyotype. The median follow-up was 26.4 months. In the subgroup analyses of major route ACAs, three-year cumulative incidence of relapse (CIR) and progression-free survival(PFS) are statistically significant in + 8[66.7% vs.23.7%, P = 0.024; 77.8% vs. 23.7%, P = 0.0087], -7[53.8% vs. 23.7%, P = 0.035%; 61.5% vs. 32.9%, P = 0.033], and complex karyotypes[42.9% vs. 23.7%, P = 0.027; 47.6% vs. 23.7%] compared with t(9;22) sole. Additionally, the 3-year CIR for Ph + ALL with + der(22) is 44% vs. 23.7% for t(9;22) sole(P = 0.045). The 3-year overall survival (OS) in the - 7 group is 46.5%, which is statistically significant compared with the other groups(P = 0.001). In multivariate analyses, three years CIR and PFS are statistically significant in + der(22), + 8, -7 and complex karyotype compared with t(9;22) sole(P < 0.05). More importantly, Ph + ALL with - 7 was negatively associated with the rate of 3-year OS(P = 0.012). Thus, ACAs at diagnosis appear to have a significant prognostic impact on transplantation outcomes in patients with Ph + ALL.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.