Downing and his colleagues conducted gene analyses of 221 children with high-risk ALL who were being treated for the disease as part of another study.
Deletions or changes in the IKAROS gene (of which there were several) that were found in slightly more than one-quarter of the patients were associated with a worse outcome. The findings were validated in a second group of 258 children.
IKAROS produces the IKAROS protein, which is involved in regulating other genes.
"The mutations of IKAROS were shown to be independent prognostic indicators, they had high value to identify patients at high risk of relapse over and above known risk factors," Downing said. "Identification of these lesions at the time of diagnosis would provide new information to better identify those patients."
It's unknown how the gene works at this point, but Downing speculated that it has to do with the gene's role in regulating the formation of lymphocyte cells.
Diagnostic tests need to be developed before the study results -- which also need to be replicated -- can be of benefit to patients, the researchers said.
There's another potential benefit down the road: new information to help find new targets for drugs.
Visit the U.S. National Cancer Institute for more on ALL in children.
SOURCES: James R. Downing, M.D., scientific director, St. Jude Children's Research Hospital, Memphis, Tenn.; Arthur Frankel, M.D., professor, medicine, Texas A&M Health Science Center College of Medicine, and director, Cancer Center, Cancer Research Institute and Division of Hematology/Oncology, Scott & White Hospital, Jan. 7, 2009, New England Journal of Medicine, online
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