A 4-year-old girl is diagnosed with B-cell acute lymphoblastic leukemia. Which cytogenetic finding in her leukemic cells carries the most favorable prognosis?
- A Hypodiploidy (fewer than 44 chromosomes)
- B t(9;22)(q34;q11.2)
- C Hyperdiploidy (more than 50 chromosomes) ✓
- D t(4;11)(q21;q23)
Correct answer: C. Hyperdiploidy (more than 50 chromosomes)
Explanation
High hyperdiploidy (51 to 65 chromosomes) in childhood B-ALL correlates with excellent response to antimetabolite-based therapy because hyperdiploid blasts accumulate drug metabolites and undergo enhanced apoptosis. Hypodiploidy, t(9;22) (Philadelphia-positive ALL), and t(4;11) involving KMT2A are all adverse-risk lesions associated with relapse and poor survival, making them the wrong choices.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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