How do chromosome abnormalities affect the prognosis of acute lymphoblastic leukemia (ALL)?

Updated: Oct 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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The effect of chromosome number on prognosis is displayed in Table 1, below.

Table 1. Effect of Chromosome Number on Prognosis (Open Table in a new window)

Chromosome Number

3-Year Event-Free Survival

Near tetraploidy


Normal karyotype


Hyperdiploidy >50


Hyperdiploidy 47-50






In a study of 428 patients with Philadelphia chromosome negative ALL treated at MD Anderson Cancer Center, 43% had a diploid karyotype. Other patients had 3 or 4 chromosomal abnormalities (6%), 5 or more chromosome abnormalities (7%), low hypodiploidy/near-triploidy (6%), or tetraploidy (1%). Six percent of patients had an mixed-lineage leukemia rearrangement and 11% had other recurrent chromosomal abnormalities. The 5-year overall survival rate was 47%. The overall survival of patients with 3 or 4 chromosomal abnormalities was similar to that of patients with diploid ALL (51%), whereas the overall survival for patients with 5 or more abnormalities was 28%. Complex karyotype and hypodiploidy/near triploidy retained their prognostic importance independent of minimal residual disease (MRD) status after treatment. [16]

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