RAPID COMMUNICATION Case-Control Study Suggests a Favorable Impact of TEL Rearrangement in Patients With B-Lineage Acute Lymphoblastic Leukemia Treated With Antimetabolite-Based Therapy: A Pediatric Oncology Group Study

TEL gene rearrangement is the most common genetic lesion on a two-sided logistic regression analysis, stratified for age (subdivided at 10 years), leukocyte count (subdivided at in pediatric acute lymphoblastic leukemia (ALL), occurring in about 25% of B-lineage cases. We previously showed that, 50,000), and gender, the estimated odds of failing by 4 years in the germline TEL group is 5.4 times that of the rearranged among patients treated on St Jude protocols, TEL rearrangement independently conferred an excellent prognosis. To TEL group, with 95% confidence from 1.9 to 15.6, two-sided P ! .0009. Thus, the presence of a rearranged TEL gene is extend these results to patients treated with antimetabolitebased therapy, we performed Southern blot analysis to dealso associated with an improved survival among patients treated with antimetabolite-based therapy. Our results inditermine the TEL gene status of 104 cases of B-lineage ALL treated on Pediatric Oncology Group 8602, matched on age, cate that all newly diagnosed ALL patients should be screened for TEL gene rearrangements and suggest that gender, and leukocyte count. There were 52 failures among the 77 patients with germline TEL, compared with only 8 these patients are candidates for less intensive therapy.