title: Adult patients with de novo acute myeloid leukemia and t(9; 11)(p22; q23) have a superior outcome to patients with other translocations involving band 11q23: a cancer and leukemia group B study.
abstract: Following reports of childhood acute myeloid leukemia (AML) showing that patients with t(9; 11)(p22; q23) have a better prognosis than those with translocations between 11q23 and other chromosomes, we compared response to therapy and survival of 24 adult de novo AML patients with t(9; 11) with those of 23 patients with other 11q23 translocations [t(11q23)]. Apart from a higher proportion of French-American-British (FAB) M5 subtype in the t(9; 11) group (83% v 43%, P = .006), the patients with t(9; 11) did not differ significantly from patients with t(11q23) in terms of their presenting clinical or hematologic features. Patients with t(9; 11) more frequently had an extra chromosome(s) 8 or 8q as secondary abnormalities (46% v 9%, P = .008). All patients received standard cytarabine and daunorubicin induction therapy, and most of them also received cytarabine-based intensification treatment. Two patients, both with t(9; 11), underwent bone marrow transplantation (BMT) in first complete remission (CR). Nineteen patients (79%) with t(9; 11) and 13 (57%) with t(11q23) achieved a CR (P = .13). The clinical outcome of patients with t(9; 11) was significantly better: the median CR duration was 10.7 versus 8.9 months (P = .02), median event-free survival was 6.2 versus 2.2 months (P = .009), and median survival was 13.2 versus 7.7 months (P = .009). All patients with t(11q23) have died, whereas seven (29%) patients with t(9; 11) remain alive in first CR. Seven of eight patients with t(9; 11) who received postremission regimens with cytarabine at a dose of 100 (four patients) or 400 mg/m2 (2 patients) or who did not receive postremission therapy (2 patients) have relapsed. In contrast, 7 (64%) of 11 patients who received intensive postremission chemotherapy with high-dose cytarabine (at a dose 3 g/m2) (5 patients), or underwent BMT (2 patients) remain in continuous CR. We conclude that the outcome of adults with de novo AML and t(9; 11) is more favorable than that of adults with other 11q23 translocations; this is especially true for t(9; 11) patients who receive intensive postremission therapy.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: K
authors.initials: K
authors.lastname: Mrózek
authors.forename: K
authors.initials: K
authors.lastname: Heinonen
authors.forename: D
authors.initials: D
authors.lastname: Lawrence
authors.forename: A J
authors.initials: AJ
authors.lastname: Carroll
authors.forename: P R
authors.initials: PR
authors.lastname: Koduru
authors.forename: K W
authors.initials: KW
authors.lastname: Rao
authors.forename: M P
authors.initials: MP
authors.lastname: Strout
authors.forename: R E
authors.initials: RE
authors.lastname: Hutchison
authors.forename: J O
authors.initials: JO
authors.lastname: Moore
authors.forename: R J
authors.initials: RJ
authors.lastname: Mayer
authors.forename: C A
authors.initials: CA
authors.lastname: Schiffer
authors.forename: C D
authors.initials: CD
authors.lastname: Bloomfield
mesh_terms: D000208:Acute Disease; D000328:Adult; D002869:Chromosome Aberrations; D002880:Chromosomes, Human, Pair 11; D002898:Chromosomes, Human, Pair 8; D002899:Chromosomes, Human, Pair 9; D004268:DNA-Binding Proteins / Q000235:genetics; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D007951:Leukemia, Myeloid / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D051788:Myeloid-Lymphoid Leukemia Protein; D011519:Proto-Oncogenes; D012074:Remission Induction; D014157:Transcription Factors; D014178:Translocation, Genetic; D016896:Treatment Outcome; D016335:Zinc Fingers
chemical_list: D004268:DNA-Binding Proteins; C497422:KMT2A protein, human; D014157:Transcription Factors; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase