Definition: Given a context passage, generate a question from the passage such that its answer is shortest continous span from the passage.
Input: Philadelphia (Ph) chromosome positive acute lymphoblastic leukemia (ALL) is a common cytogenetic abnormality associated with poor outcome in adults. This preliminary study, in the absence of substantial evidence, reported the prevalence of the BCR-ABL gene fusion in ALL patients by RT-PCR in Pakistan. Moreover, the prognostic significance of BCR-ABL fusion along with other characteristics was also ascertained. One hundred forty six newly diagnosed ALL patients treated at our center between 2005 and 2008 comprised the study group. The patients were treated with a Children and Leukemia Group B induction regimen. Among these patients, BCR-ABL fusion oncogene was present in 43 of 78 patients (55%). A statistically significant difference in BCR-ABL-positivity within three age groups (<20 years, 20-50 years, >50 years) was observed (P= 0.001). The median age was significantly higher in the BCR-ABL+ group (30 vs 19 years; P= 0.001). BCR-ABL+ patients were also characterized by higher median WBC counts (96,000/L vs 23,000//L, P= 0.002). Complete remission was achieved in 74% BCR-ABL- patients and 35% BCR-ABL+ patients (P= 0.001). Only 10% of BCR-ABL- patients achieved continued complete remission (CR). None of the BCR-ABL+ patients maintained a CR further to induction therapy. With the available therapeutic protocol, the presence of a BCR-ABL fusion predicted a lower survival (P= 0.001). A high prevalence of BCR-ABL gene fusion was observed that appeared as a poor prognostic factor. Identification of this genetic entity at diagnosis is crucial for understanding the nature of adult ALL and for deciding optimal treatment.
