Chromosome Abnormalities Affect Outcomes of Neuroblastoma

Chromosome Abnormalities Affect Outcomes of Neuroblastoma

According to a recent article published in the New England Journal of Medicine, patients with neuroblastoma who have chromosomal abnormalities referred to as Unb11q LOH and 1p36 LOH tend to have worse outcomes than patients without these abnormalities. Patients with a worse prognosis according to these abnormalities may wish to seek more aggressive treatment or participate in a clinical trial evaluating novel therapeutic approaches.

Neuroblastoma is a disease in which cancerous cells form in the nerve tissues of the adrenal gland, neck, chest, or spinal cord. Although neuroblastoma is rare (it affects roughly 650 children and adolescents in the U.S. each year), it is the most common malignancy diagnosed in infants.

The severity of neuroblastoma is classified as “high”, “intermediate”, or “low”; classifications refer to the risk of a cancer recurrence or cancer progression following standard therapies. Patients classified as “low” have a significantly improved outcome compared to those classified as “high”.

Although some markers have already been established that help classify patients with neuroblastoma, researchers continue to define other variables that may help stratify patients with their outcomes; this research is part of an effort to individualize therapeutic approaches for patients with this disease.

Researchers affiliated with the Children’s Oncology Group recently conducted a study to link possible chromosomal abnormalities with outcomes for patients diagnosed with neuroblastoma. The study included 915 samples of neuroblastoma, which were screened through laboratory processes for abnormalities and compared to patient outcomes.

Individuals with the abnormality unb11qLOH or 1p36LOH had significantly worse survival at 3 years than individuals without these abnormalities:

  • 3-year event-free survival (no cancer recurrences, no cancer progression, no death) rates were 50% in individuals with the unb11qLOH abnormality, compared with 74% in patients without this abnormality.
  • 3-year overall survival was 66% in patients with the unb11qLOH abnormality, compared with 83% for those without this abnormality.
  • Both Unb11qLOH and 1p36LOH were associated with significantly worse progression-free survival in patients, even among patients who were considered to be in low or intermediate-risk groups based on historically accepted variables.

The researchers concluded that both Unb11qLOH and 1p36LOH are associated with a significantly worse prognosis in patients diagnosed with neuroblastoma. They state that these chromosomal abnormalities should be considered when conducting clinical trials evaluating treatment regimens in patients with neuroblastoma.

Patients diagnosed with neuroblastoma, or parents of patients diagnosed with neuroblastoma, may wish to speak with their physician regarding the status of Unb11qLOH and 1p36LOH in their disease and possible treatment implications of these results.

Reference: Attiyeh E, London W, Mosse Y, et al. Chromosome 1p and 11q Deletions and Outcomes in Neuroblastoma. New England
Journal of Medicine. 2005; 353:2243-2253

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