Question:
Which of the following is a poor prognostic factor in acute lymphoblastic leukemia (ALL)?
Which of the following is a poor prognostic factor in acute lymphoblastic leukemia (ALL)?
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The Philadelphia chromosome and MLL rearrangement signal a bad outcome.
Updated On: Jun 24, 2026
- Hyperdiploidy
- t(9;22) and t(4;11)
- Age 2 to 8 years
- Total leukocyte count < 50000
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The Correct Option is B
Solution and Explanation
Step 1: Recall the prognostic stratification of ALL. Cytogenetics, age and presenting leukocyte count all influence outcome.
Step 2: Review the good prognostic features in the options. Hyperdiploidy (more than 50 chromosomes) is a favourable finding. Age between 2 and 8 (roughly 1 to 10) years is favourable. A presenting total leukocyte count below 50000 is also favourable.
Step 3: Identify the adverse feature. The Philadelphia chromosome t(9;22) (BCR-ABL) and the MLL rearrangement t(4;11) are both classic poor prognostic cytogenetic abnormalities in ALL, associated with high relapse rates.
Step 4: Conclusion. The poor prognostic factor is the t(9;22) and t(4;11) translocations.
The medically correct and printed answer is option 2.
Step 2: Review the good prognostic features in the options. Hyperdiploidy (more than 50 chromosomes) is a favourable finding. Age between 2 and 8 (roughly 1 to 10) years is favourable. A presenting total leukocyte count below 50000 is also favourable.
Step 3: Identify the adverse feature. The Philadelphia chromosome t(9;22) (BCR-ABL) and the MLL rearrangement t(4;11) are both classic poor prognostic cytogenetic abnormalities in ALL, associated with high relapse rates.
Step 4: Conclusion. The poor prognostic factor is the t(9;22) and t(4;11) translocations.
The medically correct and printed answer is option 2.
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