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Allogeneic hematopoietic stem cell transplantation for adult patients with t(4;11)(q21;q23) KMT2A/AFF1 B-cell precursor acute lymphoblastic leukemia in first complete remission: impact of pretransplant measurable residual disease (MRD) status. An analysis from the Acute Leukemia Working Party of the EBMT
J. Esteve, S. Giebel, M. Labopin, T. Czerw, D. Wu, L. Volin, G. Socié, I. Yakoub-Agha, J. Maertens, JJ. Cornelissen, A. Pigneux, A. Shimoni, R. Schwerdtfeger, H. Labussière-Wallet, N. Russell, A. Schattenberg, P. Chevallier, V. Koza, R. Foà, C....
Language English Country Great Britain
Document type Journal Article, Multicenter Study
NLK
ProQuest Central
from 2000-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Nursing & Allied Health Database (ProQuest)
from 2000-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 2000-01-01 to 1 year ago
Public Health Database (ProQuest)
from 2000-01-01 to 1 year ago
- MeSH
- DNA-Binding Proteins genetics metabolism MeSH
- Adult MeSH
- Histone-Lysine N-Methyltransferase genetics metabolism MeSH
- Transplantation, Homologous MeSH
- Remission Induction MeSH
- Humans MeSH
- Chromosomes, Human, Pair 11 genetics MeSH
- Chromosomes, Human, Pair 4 genetics MeSH
- Survival Rate MeSH
- Follow-Up Studies MeSH
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma genetics pathology therapy MeSH
- Transplantation Conditioning MeSH
- Prognosis MeSH
- Myeloid-Lymphoid Leukemia Protein genetics metabolism MeSH
- Retrospective Studies MeSH
- Neoplasm, Residual genetics pathology therapy MeSH
- Transcriptional Elongation Factors genetics metabolism MeSH
- Translocation, Genetic MeSH
- Hematopoietic Stem Cell Transplantation methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
Adult B-cell precursor acute lymphoblastic leukemia (BCP-ALL) with t(4;11)(q21;q23);KMT2A/AFF1 is a poor-prognosis entity. This registry-based study was aimed to analyze outcome of patients with t(4;11) BCP-ALL treated with allogeneic hematopoietic stem cell transplantation (alloHSCT) in first complete remission (CR1) between 2000 and 2017, focusing on the impact of measurable residual disease (MRD) at the time of transplant. Among 151 patients (median age, 38) allotransplanted from either HLA-matched siblings or unrelated donors, leukemia-free survival (LFS) and overall survival (OS) at 2 years were 51% and 60%, whereas relapse incidence (RI) and non-relapse mortality (NRM) were 30% and 20%, respectively. These results were comparable to a cohort of contemporary patients with diploid normal karyotype (NK) BCP-ALL with equivalent inclusion criteria (n = 567). Among patients with evaluable MRD pre-alloHSCT, a negative status was the strongest beneficial factor influencing LFS (hazard ratio [HR] = 0.2, p < 0.001), OS (HR = 0.14, p < 0.001), RI (HR = 0.23, p = 0.001), and NRM (HR = 0.16, p = 0.002), with a similar outcome to MRD-negative NK BCP-ALL patients. In contrast, among patients with detectable pretransplant MRD, outcome in t(4;11) BCP-ALL was inferior to NK BCP-ALL (LFS: 27% vs. 50%, p = 0.02). These results support indication of alloHSCT in CR1 for t(4;11) BCP-ALL patients, provided a negative MRD status is achieved. Conversely, pre-alloHSCT additional therapy is warranted in MRD-positive patients.
Charles University Hospital Pilsen Czech Republic
CHU Bordeaux Hôpital Haut Lévêque Pessac France
Department d'Hematologie CHU Nantes Nantes France
Department of Hematology and Oncology Augsburg University Hospital Augsburg Germany
Department of Hematology Hospital Saint Antoine Paris France
Department of Hematology Nijmegen Medical Centre Radboud University Nijmegen The Netherlands
Department of Hematology The 1st Hospital Affiliated to Soochow University Suzhou China
Department of Translational and Precision Medicine Sapienza University Rome Italy
Division of Hematology Hospital St Louis and University Paris Paris France
EBMT Paris Study Office Department of Hematology and Cell Therapy Hôpital Saint Antoine Paris France
Erasmus MC Daniel den Hoed Cancer Centre Rotterdam The Netherlands
Hematology Department Hospital Clínic of Barcelona IDIBAPS University of Barcelona Barcelona Spain
Hematology Division Chaim Sheba Medical Center Tel Hashomer Israel
Hôpital Claude Huriez Lille France
Hôpital Edouard Herriot Lyon France
Nottingham University Hospitals and University of Nottingham Nottingham UK
University Hospital Center Zagreb School of Medicine University of Zagreb Zagreb Croatia
References provided by Crossref.org
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