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Frequency and prognostic significance of t(v;11q23)/KMT2A rearrangements in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols

Autores: Motllo, C. (Autor de correspondencia); Ribera, J. M.; Morgades, M.; Granada, I.; Montesinos, P.; Brunet, S.; Bergua, J.; Tormo, M.; García-Boyero, R.; Sarra, J.; del Potro, E.; Grande García, Carlos; Barba, P.; Bernal, T.; Amigo, M. L.; Grau, J.; Cervera, J.; Feliu, E.; PETHEMA Grp; Spanish Soc Hematology
Título de la revista: LEUKEMIA AND LYMPHOMA
ISSN: 1042-8194
Volumen: 58
Número: 1
Páginas: 145-152
Fecha de publicación: 2017
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.