Long-term disease-free survivors with cytogenetically normal acute myeloid leukemia and MLL partial tandem duplication: a Cancer and Leukemia Group B study.
The clinical impact of MLL partial tandem duplication (MLL-PTD) was evaluated in 238 adults aged 18 to 59 years with cytogenetically normal (CN) de novo acute myeloid leukemia (AML) who were treated intensively on similar Cancer and Leukemia Group B protocols 9621 and 19808. Twenty-four (10.1%) patients harbored an MLL-PTD. Of those, 92% achieved complete remission (CR) compared with 83% of patients without MLL-PTD (P=.39). Neither overall survival nor disease-free survival significantly differed between the 2 groups (P=.67 and P=.55, respectively). Thirteen MLL-PTD(+) patients relapsed within 1.4 years of achieving CR. MLL-PTD(+) patients who relapsed more often had other adverse CN-AML-associated molecular markers. In contrast with previously reported studies, 9 (41%) MLL-PTD(+) patients continue in long-term first remission (CR1; range, 2.5-7.7 years). Intensive consolidation therapy that included autologous peripheral stem-cell transplantation during CR1 may have contributed to the better outcome of this historically poor-prognosis group of CN-AML patients with MLL-PTD.
Whitman
Susan P
SP
Division of Hematology and Oncology, Department of Internal Medicine, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43240, USA. susan.whitman@osumc.edu
Ruppert
Amy S
AS
Marcucci
Guido
G
Mrózek
Krzysztof
K
Paschka
Peter
P
Langer
Christian
C
Baldus
Claudia D
CD
Wen
Jing
J
Vukosavljevic
Tamara
T
Powell
Bayard L
BL
Carroll
Andrew J
AJ
Kolitz
Jonathan E
JE
Larson
Richard A
RA
Caligiuri
Michael A
MA
Bloomfield
Clara D
CD
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D007951:Leukemia, Myeloid / Q000235:genetics* / Q000401:mortality*; D008875:Middle Aged; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics*; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D016019:Survival Analysis; D017741:Survivors; D020080:Tandem Repeat Sequences
C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase