Allogeneic hematopoietic cell transplantation improves outcome of adults with t(6;9) acute myeloid leukemia: results from an international collaborative study
Year: 2019
Type: article
Study design: Observational Study
Abstract: Acute myeloid leukemia (AML) with t(6;9)(p22;q34) is a distinct entity accounting for 1-2% of AML 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 (allo-HCT) may improve survival if performed 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 years (range: 16-76), AML 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 five years was 38% (95%CI: 31-47%). Allo-HCT was performed in 117 (66%) patients, including 89 in first complete remission. Allo-HCT 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%) versus 7% (95%CI: 3-19%) and 23% (95%CI: 13-38%), respectively. For patients undergoing allo-HCT, there was no difference in overall survival rates at five years according to whether it was performed in first [53% (95%CI: 42-66%)], or second [58% (95%CI: 31-100%); n=10] complete remission 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) AML are poor with chemotherapy, and can be substantially improved with allo-HCT.
Source: Haematologica
Authors: 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, Mark J. Levis
Institutions: German Cancer Research Center, Heidelberg University, University Hospital Heidelberg, Cardiff University, Dana-Farber Cancer Institute, Massachusetts General Hospital, Hôpital André Mignot, Charité - Universitätsmedizin Berlin, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, University of Washington, Fred Hutch Cancer Center, University of Maryland, Baltimore, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Mayo Clinic, Abramson Cancer Center, University of Pennsylvania, Masaryk University, University Hospital Brno, Charles University, University Hospital Hradec Králové, University Hospital Olomouc, Palacký University Olomouc, Université Paris-Saclay, King's College London, University Hospital Bonn, University Hospital Leipzig, University Hospital Carl Gustav Carus, Nottingham University Hospitals NHS Trust, National Center for Tumor Diseases, Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,055
OpenAlex ID: W2938344810