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Ph-Like ALL: A High-Risk Subtype in Adults

Blood; 2017 Feb 2; Jain, Roberts, Jabbour, et al

A high incidence of Philadelphia chromosome (Ph)-like acute lymphoblastic leukemia (ALL) was seen in adults with B-cell ALL in a study involving 148 individuals. Moreover, outcomes were substantially worse in a subset of patients with cytokine receptor-like factor 2 (CRLF2).

Participants—all of whom had newly diagnosed B-cell ALL and received frontline chemotherapy—underwent gene expression profiling of leukemic cells. One-third had Ph-like, 31% had Ph+, and 36% had other subtypes. Among the results:

  • 6 in every 10 patients with Ph-like ALL had CRLF2 overexpression.
  • 5-year survival rate in patients with Ph-like ALL was 23%, vs 59% in those with other subtypes.
  • ~Two-thirds of Ph-like ALL patients were Hispanic.
  • Age, white blood cell count, platelet count, and Ph-like ALL were linked with inferior overall survival.
  • JAK2 mutation was linked with inferior outcomes in the CRLF2+ group.


Jain N, Roberts K, Jabbour E, et al. Ph-like acute lymphoblastic leukemia: A high-risk subtype in adults. Blood. 2017;129(5):572-581. doi:10.1182/blood-2016-07-726588.