Low Frequency of ETV6-RUNX1 (t 12; 21) in Saudi Arabian Pediatric Acute Lymphoblastic Leukemia Patients: Association with Clinical Parameters and Early Remission

  • Aljamaan, Khaled (Division of Pediatric Hematology/Oncology Department of Oncology, King Saud Bin Abdulaziz University for Health Sciences) ;
  • Aljumah, Talal khalid (Division of Pediatric Hematology/Oncology Department of Oncology, King Saud Bin Abdulaziz University for Health Sciences) ;
  • Aloraibi, Saleh (Medical Genetics/Hematology & Oncology, CLS, CoAMS and CoAMS, King Saud Bin Abdulaziz University for Health Sciences) ;
  • Absar, Muhammad (Hematology, Oncology and Pharmacogenetic Engg Sciences (HOPES) Group, Department of Zoology, Faculty of Biological Sciences, University of the Punjab) ;
  • Iqbal, Zafar (Medical Genetics/Clinical Laboratory Sciences, CoAMS, King Saud Bin Abdulaziz University for Health Sciences)
  • Published : 2015.12.03


Background: Pediatric acute lymphoblastic leukemia (pALL) patients at King Abdulaziz Medical City represent a pure Saudi Arabian population. ETV6-RUNX1 positive pALL patients have good prognosis as compared to ETV6-RUNX1 negative counterparts. Therefore, frequencies of these two patient groups have a huge consideration in treatment strategies of pALL in a given population. Different geographical locations have been reported to have different frequencies of ETV6-RUNX1 ranging from 10% in Southeast Asia to 30% in Australia. Aim: Therefore, the objective of this study was to establish the ETV6-RUNX1 status of Saudi Arabian pALL patients and its association with clinical parameters and early remission. Materials and Methods: Clinical parameters and ETV6-RUNX1 status (using FISH technique) of pALL patients attending the Pediatric Oncology Clinic, King Abdulaziz Medical City, Riyadh from 2006 to 2011 were studied. Comparisons between ETV6-RUNX1 positive and negative groups were accomplished using chi-square test or Fisher's exact test. All statistical analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC). Results: Out of 54 patients, 33 were male and 21 were females (ratio 1.57:1). B- and T-cell lineages were found in 47 (87%) and 7 (13%) patients respectively. Only 5 (9.3%) patients were ETV6-RUNX1 positive while 49(80.7%) were ETV6-RUNX1 negative. All ETV6-RUNX1 patients (100%) were of B-cell lineage and 80% (4/5) were in the 3-7 year age group. None of the ETV6-RUNX11 patients had ${\geq}5%$ blasts (no remission) at day 14 as compared with 9% in the ETV6-RUNX1 negative group (Figure 1). Conclusions: Frequency of ETV6-RUNX1 positive patients (less than 10%) in our pALL patients is much lower than reported for most European countries, North America, Australia and Japan while it is in accordance with ETV6-RUNX1 frequencies from Egypt (11.6%), Pakistan (10%), Spain (2%) and India (5-7%). This shows ethnic differences in genetics of pALL as well as higher frequencies of ETV6-RUNX1 positive pALL mostly in more industrialized countries, probably due to some industrial pollutants or westernized lifestyle.


Acute lymphoblastic leukemia;early remission;ETV6-RUNX1;translocation;Saudi Arabia


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