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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 |
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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 |
doi_str_mv | 10.4084/MJHID.2015.041 |
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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 <1×10(-3) for seven patients. 100 days after HSCT we had: MRD(neg) for seven patients and a decrease for all the others after HSCT. 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.</description><identifier>ISSN: 2035-3006</identifier><identifier>EISSN: 2035-3006</identifier><identifier>DOI: 10.4084/MJHID.2015.041</identifier><identifier>PMID: 26075048</identifier><language>eng</language><publisher>Italy: Università Cattolica del Sacro Cuore</publisher><subject>Acute Lymphoblastic Leukemia ; Bone marrow transplantation ; Minimal Residual Disease ; Original</subject><ispartof>Mediterranean journal of hematology and infectious diseases, 2015, Vol.7 (1), p.e2015041-e2015041</ispartof><rights>2015</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-3390ba06bf24acdcb97e34399a32450c90e3d8422650e51e7e1d724cdca685783</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450652/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450652/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4021,27921,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26075048$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parma, Matteo</creatorcontrib><creatorcontrib>Viganò, Clara</creatorcontrib><creatorcontrib>Fumagalli, Monica</creatorcontrib><creatorcontrib>Colnaghi, Federica</creatorcontrib><creatorcontrib>Colombo, Arianna</creatorcontrib><creatorcontrib>Mottadelli, Federica</creatorcontrib><creatorcontrib>Rossi, Vincenzo</creatorcontrib><creatorcontrib>Elli, Elena</creatorcontrib><creatorcontrib>Terruzzi, Elisabetta</creatorcontrib><creatorcontrib>Belotti, Angelo</creatorcontrib><creatorcontrib>Cazzaniga, Giovanni</creatorcontrib><creatorcontrib>Pogliani, Enrico Maria</creatorcontrib><creatorcontrib>Pioltelli, Pietro</creatorcontrib><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</title><title>Mediterranean journal of hematology and infectious diseases</title><addtitle>Mediterr J Hematol Infect Dis</addtitle><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 <1×10(-3) for seven patients. 100 days after HSCT we had: MRD(neg) for seven patients and a decrease for all the others after HSCT. 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.</description><subject>Acute Lymphoblastic Leukemia</subject><subject>Bone marrow transplantation</subject><subject>Minimal Residual Disease</subject><subject>Original</subject><issn>2035-3006</issn><issn>2035-3006</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkk1vEzEQhlcIRKvSK0fkYyo1wWt7vxQJKQRog1IVlcLVmvXOJm6968T2IuVX8xdwmlK1vtiaef3MePwmyfuUTgQtxcer75eLLxNG02xCRfoqOWaUZ2NOaf762fkoOfX-jsbFeVpy9jY5YjktMirK4-TvhbUNuR6Csh2S1jryG92OXOrVmtxof09mzWAC-TxWaAyZqSEgWe66zdrWBnzQiixxuAfsNJA5OLfT_YpcYI_71KzurevA6KDRkzAS0zQ9G21ZOt0yfkZisTCqpozFGBfTbUyeE92SH852m2B25OdQdzoEbEiwZGaMXUVw5N466P3GQB8gaNufE2gDOnJdB9D9vgEgD8-6sgbVYMCRm9ig91H7LnnTgvF4-rifJL--fb2dX46X1xeL-Ww5ViLLw5jzitZA87plAlSj6qpALnhVAWcio6qiyJtSMJZnFLMUC0ybgomohLzMipKfJIsDt7FwJzdOd-B20oKWDwHrVhJcnJFBCW2GCts6V0UueFFCJRSPxUQJrKjTOrI-HVibOA9sFPbBgXkBfZnp9Vqu7B8pYqt5xiJg9AhwdjugDzJOY_-h0KMdvEzzsuK0il6J0slBqpz13mH7VCalcm862d2tdSP3ppPRdPHCh-fNPcn_W4z_AzF306I</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Parma, Matteo</creator><creator>Viganò, Clara</creator><creator>Fumagalli, Monica</creator><creator>Colnaghi, Federica</creator><creator>Colombo, Arianna</creator><creator>Mottadelli, Federica</creator><creator>Rossi, Vincenzo</creator><creator>Elli, Elena</creator><creator>Terruzzi, Elisabetta</creator><creator>Belotti, Angelo</creator><creator>Cazzaniga, Giovanni</creator><creator>Pogliani, Enrico Maria</creator><creator>Pioltelli, Pietro</creator><general>Università Cattolica del Sacro Cuore</general><general>PAGEPress Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>2015</creationdate><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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-3390ba06bf24acdcb97e34399a32450c90e3d8422650e51e7e1d724cdca685783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Lymphoblastic Leukemia</topic><topic>Bone marrow transplantation</topic><topic>Minimal Residual Disease</topic><topic>Original</topic><toplevel>online_resources</toplevel><creatorcontrib>Parma, Matteo</creatorcontrib><creatorcontrib>Viganò, Clara</creatorcontrib><creatorcontrib>Fumagalli, Monica</creatorcontrib><creatorcontrib>Colnaghi, Federica</creatorcontrib><creatorcontrib>Colombo, Arianna</creatorcontrib><creatorcontrib>Mottadelli, Federica</creatorcontrib><creatorcontrib>Rossi, Vincenzo</creatorcontrib><creatorcontrib>Elli, Elena</creatorcontrib><creatorcontrib>Terruzzi, Elisabetta</creatorcontrib><creatorcontrib>Belotti, Angelo</creatorcontrib><creatorcontrib>Cazzaniga, Giovanni</creatorcontrib><creatorcontrib>Pogliani, Enrico Maria</creatorcontrib><creatorcontrib>Pioltelli, Pietro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Mediterranean journal of hematology and infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parma, Matteo</au><au>Viganò, Clara</au><au>Fumagalli, Monica</au><au>Colnaghi, Federica</au><au>Colombo, Arianna</au><au>Mottadelli, Federica</au><au>Rossi, Vincenzo</au><au>Elli, Elena</au><au>Terruzzi, Elisabetta</au><au>Belotti, Angelo</au><au>Cazzaniga, Giovanni</au><au>Pogliani, Enrico Maria</au><au>Pioltelli, Pietro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Mediterranean journal of hematology and infectious diseases</jtitle><addtitle>Mediterr J Hematol Infect Dis</addtitle><date>2015</date><risdate>2015</risdate><volume>7</volume><issue>1</issue><spage>e2015041</spage><epage>e2015041</epage><pages>e2015041-e2015041</pages><issn>2035-3006</issn><eissn>2035-3006</eissn><abstract>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 <1×10(-3) for seven patients. 100 days after HSCT we had: MRD(neg) for seven patients and a decrease for all the others after HSCT. 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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