High Frequency and Poor Prognosis of Late Childhood BCR-ABL-Positive and MLL-AF4-Positive ALL Define the Need for Advanced Molecular Diagnostics and Improved Therapeutic Strategies in Pediatric B-ALL in Pakistan

Background Fusion oncogenes (FOs) resulting from chromosomal abnormalitieshave an important role in leukemogenesis in pediatric B cell acute lymphoblastic leukemia(ALL). The most common FOs are BCR-ABL, MLL-AF4, ETV6- RUNX1, and TCF3-PBX1, all of which have important prognostic and drug selection implications. Moreover, frequencies of FOs have ethnic variations. We studied Pakistani frequencies of FOs, clinical pattern, and outcome in pediatric B-ALL.