Genetic defect needs aggressive treatment.

Researchers looking at a group of leukemia patients have found that a genetic defect they discovered in 1996 serves as an early warning signal, calling for a speedup in treatment. The defect is a duplication of a small part of the ALL1 gene. Those who have this alteration fall out of remission three times faster than those who don't and their survival is slightly more than half that of individuals who don't have the defect.

The gene defect appears in people suffering from acute myeloid leukemia (AML), a cancer that afflicts about one in 100,000 people. The disease increases as the population ages, and the prognosis of those afflicted worsens as they grow older. Perhaps 40% of individuals with AML can be cured using appropriate therapies. Without treatment, AML can kill in a few months.

In approximately 55% of AML cases, the chromosomes show distinctive changes that can be linked to the disease. In the remaining 45%, however, the patients show normal cytogenetics--that is, there are no obvious chromosomal changes. This particular defect appears in people who have normal cytogenetics, explains Michael Caligiuri, co-director of the Division of Hematology and Oncology and associate director for clinical cancer research in Ohio State University's Comprehensive Cancer Center...