Good Outcome for Very High Risk Adult B-cell Acute Lymphoblastic Leukaemia Carrying Genetic Abnormalities t(4;11)(q21;q23) or t(9;22)(q34;q11), if Promptly Submitted to Allogeneic Transplantation, after Obtaining a Good Molecular Remission

• Published in: Mediterranean journal of hematology and infectious diseases 2015, Vol.7 (1), p.e2015041-e2015041
• Main Authors: Parma, Matteo, Viganò, Clara, Fumagalli, Monica, Colnaghi, Federica, Colombo, Arianna, Mottadelli, Federica, Rossi, Vincenzo, Elli, Elena, Terruzzi, Elisabetta, Belotti, Angelo, Cazzaniga, Giovanni, Pogliani, Enrico Maria, Pioltelli, Pietro
• Format: Article
• Language: English
• Subjects: Acute Lymphoblastic Leukemia; Bone marrow transplantation; Minimal Residual Disease; Original
• ISSN: 2035-3006; 2035-3006
• DOI: 10.4084/MJHID.2015.041

Acute lymphoblastic leukaemia (ALL) carrying t(9;22) or t(4;11) genetic abnormalities represents a very high risk subtype of disease (VHR-ALL). Hematopoietic stem cell transplantation (HSCT) remains the best curative option not only for t(4;11) ALL, but also for t(9;22) ALL in the tyrosin-kinase inhibitors era. In the last years, low molecular level of minimal residual disease (MRD) before HSCT was reported as one of the best favourable indexes for survival in ALL. Here we observed that even these patients can show a favourable outcome if submitted to HSCT with very low MRD. We considered 18 consecutive VHR-ALL patients eligible to HSCT. 16 of them were transplanted in first remission, as soon as possible, employing myelo-ablative conditioning regimens. Molecular MRD has been evaluated before and after HSCT. Immediately before HSCT, MRD revealed: complete molecular remission (MRD(neg)) for five patients, and a level