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Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of patients with mixed‐lineage‐leukemia‐rearranged acute leukemia: Results from a prospective, multi‐center study
Author(s) -
Yu Wang,
QiFa Liu,
YaZhen Qin,
DaiHong Liu,
LanPing Xu,
Bin Jiang,
Qian Jiang,
Min Dai,
SiJian Yu,
XinMiao Jiang,
YanRong Liu,
XiaoJun Huang
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23595
Subject(s) - medicine , hematopoietic stem cell transplantation , acute leukemia , leukemia , transplantation , cumulative incidence , prospective cohort study , single center , gastroenterology , oncology
The purpose of this study is to define the role for allogeneic hematopoietic stem cell transplantation (allo‐HSCT) in mixed‐lineage‐leukemia (MLL)‐rearranged acute leukemia, which is now poorly understood. A prospective, multi‐center cohort study to determine whether allo‐HSCT could decrease relapse rates and improve long‐term survival of MLL+ leukemia patients was performed. Fifty‐six consecutive patients diagnosed with MLL–rearranged acute leukemia undergoing allo‐HSCT from two transplant centers in China were enrolled between October 2007 and October 2012. The trial was registered at www.chictr.org as # ChiCTR‐ONC‐12002739. The incidences of grades II to IV acute graft versus host disease (aGVHD) and of grades III and IV aGVHD were 28.8% (CI, 16.87–40.8%), and 14.2% (CI, 5.4–23.0%), respectively. The cumulative incidences for chronic GVHD (cGVHD) at 2 years after HSCT were 35.2% (CI, 21.2–49.2%). Up to April 30, 2013, 12 patients had relapsed and 11 died from relapse, and 37 patients were still alive without disease recurrence. The relapse and NRM rates at 3 years were 25.3% (CI, 12.7–37.9%) and 18.0% (CI, 2.6–33.4%), respectively. The probalities of overall survival and leukemia free survival were 61.8% (CI, 46.0–77.6%) and 56.3% (CI, 38.1–74.5%) at 3 years, respectively. Patients transplanted during their hematological first complete remission (CR1) had a lower relapse rate (17.9% vs. 48.1%, P = 0.03) compared with patients transplanted beyond CR1. The median overall survival for the 29 patients not receiving allo‐HSCT during the study period was 145 days from diagnosis. This study showed that allo‐HSCT could be a valuable treatment choice for MLL+ acute leukemia. Am. J. Hematol. 89:130–136, 2014. © 2013 Wiley Periodicals, Inc.