Children and adolescents with ALL and hypodiploidy with fewer than 44 chromosomes have a poor outcome despite contemporary therapy. Patients with hypodiploid leukemia cells (modal number less than 45) have a poor prognosis for cure. Event free survival (EFS) at 5 years was 20 percent in patients with hypodiploid leukemia compared to 75 percent in those patients with leukemia cells having modal numbers greater or equal to 45. Although the data are somewhat premature and the numbers of transplanted patients with hypodiploid leukemia are small, it is generally accepted that SCT in first remission offers a reasonable opportunity for cure. PDQ recommends risk stratification and stem cell transplantation for children with high risk, which included hypodiploidity.
Nachman JB, Heerema NA, Sather H, Camitta B, Forestier E, Harrison CJ, Dastugue N, Schrappe M, Pui CH, Basso G, Silverman LB, Janka-Schaub GE.Outcome of treatment in children with hypodiploid acute lymphoblastic leukemia.Blood. 2007 Aug 15;110(4):1112-5.
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