title: Long-term disease-free survivors with cytogenetically normal acute myeloid leukemia and MLL partial tandem duplication: a Cancer and Leukemia Group B study.
abstract: 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.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43240, USA. susan.whitman@osumc.edu
authors.forename: Susan P
authors.initials: SP
authors.lastname: Whitman
authors.forename: Amy S
authors.initials: AS
authors.lastname: Ruppert
authors.forename: Guido
authors.initials: G
authors.lastname: Marcucci
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Mrózek
authors.forename: Peter
authors.initials: P
authors.lastname: Paschka
authors.forename: Christian
authors.initials: C
authors.lastname: Langer
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Baldus
authors.forename: Jing
authors.initials: J
authors.lastname: Wen
authors.forename: Tamara
authors.initials: T
authors.lastname: Vukosavljevic
authors.forename: Bayard L
authors.initials: BL
authors.lastname: Powell
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Carroll
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Kolitz
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.forename: Michael A
authors.initials: MA
authors.lastname: Caligiuri
authors.forename: Clara D
authors.initials: CD
authors.lastname: Bloomfield
mesh_terms: 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
chemical_list: C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase