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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

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 inh...

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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
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container_title Mediterranean journal of hematology and infectious diseases
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creator 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
description 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
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After the tapering of immunosuppressive drugs, 13 patients reached the MRD(neg) in a median time of 8 months (range 3-16). In the intention to treat analysis, 14/18 patients are alive and disease free at the date of analysis. Overall survival and event free survival is of 78% and 66% respectively, with an average follow-up of 45 months (range 6-84) since HSCT. Early transplantation with low MRD level seems to be correlated with a favourable outcome also in VHR-ALL.</abstract><cop>Italy</cop><pub>Università Cattolica del Sacro Cuore</pub><pmid>26075048</pmid><doi>10.4084/MJHID.2015.041</doi><oa>free_for_read</oa></addata></record>
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subjects Acute Lymphoblastic Leukemia
Bone marrow transplantation
Minimal Residual Disease
Original
title 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
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