Allogeneic hematopoietic cell transplantation improves outcome of adults with t(6;9) acute myeloid leukemia - results from an international collaborative study
Acute myeloid leukemia with t(6;9)(p22;q34) is a distinct entity accounting for 1-2% of acute myeloid leukemia cases. A substantial proportion of these patients have a concomitant FLT3-ITD. While outcomes are dismal with intensive chemotherapy, limited evidence suggests allogeneic hematopoietic cell...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2020
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| In: |
Haematologica
Year: 2020, Volume: 105, Issue: 1, Pages: 161-169 |
| ISSN: | 1592-8721 |
| DOI: | 10.3324/haematol.2018.208678 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3324/haematol.2018.208678 Verlag, kostenfrei, Volltext: http://www.haematologica.org/content/early/2019/04/15/haematol.2018.208678 
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| Author Notes: | Sabine Kayser, Robert K. Hills, Marlise R. Luskin, Andrew M. Brunner, Christine Terré, Jörg Westermann, Kamal Menghrajani, Carole Shaw, Maria R. Baer, Michelle A. Elliott, Alexander E. Perl, Zdeněk Ráčil, Jiri Mayer, Pavel Zak, Tomas Szotkowski, Stéphane de Botton, David Grimwade, Karin Mayer, Roland B. Walter, Alwin Krämer, Alan K. Burnett, Anthony D. Ho, Uwe Platzbecker, Christian Thiede, Gerhard Ehninger, Richard M. Stone, Christoph Röllig, Martin S. Tallman, Elihu H. Estey, Carsten Müller-Tidow, Nigel H. Russell, Richard F. Schlenk, and Mark J. Levis |
| Summary: | Acute myeloid leukemia with t(6;9)(p22;q34) is a distinct entity accounting for 1-2% of acute myeloid leukemia cases. A substantial proportion of these patients have a concomitant FLT3-ITD. While outcomes are dismal with intensive chemotherapy, limited evidence suggests allogeneic hematopoietic cell transplantation may improve survival if applied early during first complete remission. We report on a cohort of 178 patients with t(6;9)(p22;q34) within an international, multicenter collaboration. Median age was 46 (range: 16-76) years, acute myeloid leukemia was de novo in 88%, FLT3-ITD was present in 62%, and additional cytogenetic abnormalities in 21%. Complete remission was achieved in 81% (n=144), including 14 patients who received high-dose cytarabine after initial induction failure. With a median follow-up of 5.43 years, estimated overall survival at 5 years was 38% (95%-CI, 31-47%). Allogeneic hematopoietic cell transplantation was performed in 117 (66%) patients, including 89 in first complete remission. Allogeneic hematopoietic cell transplantation in first complete remission was associated with higher 5-year relapse-free and overall survival as compared to consolidation chemotherapy (45% [95%-CI, 35-59%] and 53% [95%-CI, 42-66%], vs. 7% [95%-CI, 3-19%] and 23% [95%-CI, 13-38%]. For patients undergoing allogeneic hematopoietic cell transplantation, overall survival rates at 5 years did not differ whether performed in first (53% [95%-CI, 42-66%]), or second complete remission (58% [95%-CI, 31-100%]; n=10) or with active disease/relapse (54% [95%-CI, 34-84%]; n=18) (P=0.67). Neither FLT3-ITD nor additional chromosomal abnormalities impacted survival. In conclusion, outcomes of t(6;9)(p22;q34) acute myeloid leukemias are poor with chemotherapy, and can be substantially improved with allogeneic hematopoietic cell transplantation. |
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| Item Description: | Pre-published: April 19, 2019 Gesehen am 27.01.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1592-8721 |
| DOI: | 10.3324/haematol.2018.208678 |