Open AccessPrognostic significance of various 11q23/KMT2A rearrangements in infants with acute lymphoblastic leuekemia
Author(s) -
Grigory Tsaur,
Tatyana Riger,
Alexander Popov,
Anatoly Kustanovich,
Ю. В. Ольшанская,
Т. В. Наседкина,
Alexander Solodovnikov,
Egor Shorikov,
Anna Demina,
Olga Plekhanova,
Ekateriokhrina,
Т. Ю. Вержбицкая,
Olga Streneva,
Olga Makarova,
Oleg Arakaev,
Л. И. Савельев,
О. В. Алейникова,
Elena Lapotentova,
Natalia Miakova,
В. В. Фоминых,
К. Л. Кондратчик,
Э. Г. Бойченко,
Natalia Ponomareva,
А. И. Карачунский,
А. Г. Румянцев,
Larisa Fechina
Publication year - 2021
Publication title -
voprosy gematologii/onkologii i immunopatologii v pediatrii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 3
eISSN - 2414-9314
pISSN - 1726-1708
DOI - 10.24287/1726-1708-2021-20-1-27-39
Subject(s) - medicine , cumulative incidence , chromosomal translocation , white blood cell , lymphoblastic leukemia , incidence (geometry) , oncology , acute leukemia , gastroenterology , pediatrics , leukemia , biology , genetics , cohort , gene , physics , optics
The purpose of this work was evaluation of prognostic significance of 11q23/KMT2A rearrangements in infants (aged under 365 days) with B-cell precursor acute lymphoblastic leukemia (ALL) enrolled in Russian-Belarus multicenter trial MLLBaby. This study is supported by the Independent Ethics Committee and approved by the Academic Council of the Research Institute of Medical Cell Technologies (Ekaterinburg). Various 11q23/KMT2A rearrangements were revealed in 100 (72%) of 139 patients. Event-free survival (EFS) in the intermediate risk group of MLL-Baby trial was 35.1% (standard error (SE) 6.9%), in the high risk group – 38.3% (SE 7.1%) (p = 0.941). The most unfavorable prognosis had infants with translocation t(9;11)/KMT2A-MLLT3: EFS 18.8% (SE 9.8%), cumulative incidence of relapse (CIR) 75.0% (SE 9.7%). Intermediate results were obtained in patients with translocations t(4;11)/KMT2A-AFF1 and t(11;19)/KMT2A-MLLT1: EFS 36.9% (SE 7,2%) and 32,7% (SE 10.4%), respectively; CIR 46.3% (SE 7.8%) and 50.9% (SE 12.3%). The most favorable treatment outcome was achieved in infants carrying translocation t(10;11)(p12;q23)/KMT2A-MLLT10: EFS 83.3% (SE 15.2%), CIR 0,0%. In the multivariate analysis unfavorable outcome of KMT2A-rearranged infant ALL was associated with initial CNS involvement (p = 0.020), initial white blood cell count higher than 300 × 109 /L (p = 0.028), more than 5% blast cells on day 15 in bone marrow (p = 0.012) and presence of translocation t(11;19)/KMT2A-MLLT1 (p = 0.012).