Frequency and prognostic significance of t(v;11q23)/KMT2A rearrangements in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols
Por:
Motllo, C, Ribera, JM, Morgades, M, Granada, I, Montesinos, P, Brunet, S, Bergua, J, Tormo, M, Garcia-Boyero, R, Sarra, J, del Potro, E, Grande, C, Barba, P, Bernal, T, Amigo, ML, Grau, J, Cervera, J, Feliu, E
Publicada:
1 ene 2017
Resumen:
The karyotype is an important predictor of outcome in acute lymphoblastic leukemia (ALL). Rearrangements of the 11q23 region involving the KMT2A gene confer an unfavorable prognosis. Forty-six adult ALL patients from the PETHEMA Group treated with risk-adapted protocols, with t(v;11q23) were selected for this study. Complete response (CR) was attained in 38 patients; 25 remained in CR after consolidation. Twelve (48%) received allogeneic hematopoietic stem cell transplantation (HSCT) and 13 delayed intensification and maintenance. The 5-year CR duration probability was 37% (95% CI, 19%-55%). A trend for a longer CR duration was observed in patients undergoing HSCT vs. those receiving chemotherapy. The 5-year overall survival (OS) probability was 20% (95% CI, 5%-35%). The OS was better, albeit not significant, in patients with a MRD level< 0.1% after induction (39% [95% CI, 14%-64%] vs. 13% [95% CI, 0%-36%]). Specific treatment approaches are required to improve the outcome of patients with KMT2A-rearrangements.
Filiaciones:
Motllo, C:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Ribera, JM:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Morgades, M:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Granada, I:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Montesinos, P:
Hosp Univ, Dept Hematol, Valencia, Spain
Politecn La Fe, Valencia, Spain
Brunet, S:
Hosp Sant Pau, Dept Hematol, Barcelona, Spain
Bergua, J:
Hosp San Pedro Alcantara, Dept Hematol, Caceres, Spain
Tormo, M:
Hosp Clin Univ, Dept Hematol, Valencia, Spain
Garcia-Boyero, R:
Gen Hosp, Dept Hematol, Castellon de La Plana, Spain
Sarra, J:
ICO Hosp Duran & Reynals, Dept Hematol, Lhospitalet De Llobregat, Spain
del Potro, E:
Hosp Clin San Carlos, Dept Hematol, Madrid, Spain
Grande, C:
Hosp 12 Octubre, Dept Hematol, Madrid, Spain
Barba, P:
Hosp Valle De Hebron, Dept Hematol, Barcelona, Spain
Bernal, T:
Hosp Univ Cent Asturias, Dept Hematol, Oviedo, Spain
Amigo, ML:
Hosp Morales Messeguer, Dept Hematol, Murcia, Spain
Grau, J:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Cervera, J:
Hosp Univ, Dept Hematol, Valencia, Spain
Politecn La Fe, Valencia, Spain
Feliu, E:
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, ICO Hosp Germans Trias & Pujol, Dept Hematol, Badalona, Spain
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