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Acute Myeloid Leukemia
Allogeneic hematopoietic cell transplantation improves outcome of adults with t(6;9) acute myeloid leukemia: results from an international collaborative study
Sabine Kayser,1,2 Robert K. Hills,3 Marlise R. Luskin,4 Andrew M. Brunner,5 Christine Terré,6 Jörg Westermann,7 Kamal Menghrajani,8 Carole Shaw,9,10 Maria R. Baer,11,12 Michelle A. Elliott,13 Alexander E. Perl,14 Zdeněk Ráčil,15
Jiri Mayer,15 Pavel Zak,16 Tomas Szotkowski,17 Stéphane de Botton,18
David Grimwade,19* Karin Mayer,20 Roland B. Walter,9,10,21 Alwin Krämer,1,2
Alan K. Burnett,3 Anthony D. Ho,1 Uwe Platzbecker,22 Christian Thiede,23 Gerhard Ehninger,23 Richard M. Stone,4 Christoph Röllig,23 Martin S. Tallman,8 Elihu H. Estey,9,10 Carsten Müller-Tidow,1 Nigel H. Russell,24
Ferrata Storti Foundation
Haematologica 2020 Volume 105(1):161-169
Richard F. Schlenk25 and Mark J. Levis26
1Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany; 2German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; 3Cardiff University School of Medicine, Cardiff, UK; 4Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; 5Massachusetts General Hospital, Boston, MA, USA; 6Laboratory of Hematology, André Mignot Hospital, Le Chesnay, France; 7Department of Hematology, Oncology and Tumor Immunology, Charité-University Medical Center, Campus Virchow Clinic, Berlin, Germany; 8Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA; 9Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; 10Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA; 11University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; 12Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 13Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; 14Division of Hematology and Oncology, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 15Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic; 164th Department of Internal Medicine- Hematology, Faculty of Medicine, Charles University and University Hospital Hradec Králové, Hradec Králové, Czech Republic; 17Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic; 18Université Paris-Saclay, Gustave Roussy Villejuif, France; 19Department of Medical & Molecular Genetics, King’s College London, Faculty of Life Sciences and Medicine, London, UK; 20Medical Clinic III for Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany; 21Department of Epidemiology, University of Washington, Seattle, WA, USA; 22Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany; 23Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany; 24Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK; 25NCT Trial Center, National Center for Tumor Diseases, Heidelberg, Germany and 26Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
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 per- formed early during first complete remission. We report on a cohort of 178 patients with t(6;9)(p22;q34) within an international, multicenter collabora- tion. 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 com-
Correspondence:
SABINE KAYSER
s.kayser@dkfz-heidelberg.de
Received: January 21, 2019. Accepted: April 15, 2019. Pre-published: April 19, 2019.
doi:10.3324/haematol.2018.208678
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/105/1/161
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