Frequency and prognostic significance of t(v;11q23)/KMT2A rearrangements in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols. Issue 1 (2nd January 2017)

• Record Type: Journal Article
• Authors: Motlló, Cristina; Ribera, Josep-Maria; Morgades, Mireia; Granada, Isabel; Montesinos, Pau; Brunet, Salut; Bergua, Juan; Tormo, Mar; García-Boyero, Raimundo; Sarrà, Josep; del Potro, Eloy; Grande, Carlos; Barba, Pere; Bernal, Teresa; Amigo, María-Luz; Grau, Javier; Cervera, José; Feliu, Evarist
• Is Part Of: Leukemia & lymphoma. Volume 58:Issue 1(2017)
• Page Start: 145
• Page End: 152
• Publication Date: 2017-01-02
• Subjects: KMT2A/MLL -- acute lymphoblastic leukemia -- MRD; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2016.1177182
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: 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.