title: Outcome of allogeneic hematopoietic stem-cell transplantation for adult patients with AML and 11q23/MLL rearrangement (MLL-r AML).
abstract: Acute myeloid leukemia (AML) with 11q23/MLL rearrangement (MLL-r AML) is allocated to the intermediate- or high-risk cytogenetic prognostic category depending on the MLL fusion partner. A more favorable outcome has been reported in patients receiving an allogeneic hematopoietic stem-cell transplantation (alloHSCT), but this has not been confirmed in large series. We analyzed the outcome of alloHSCT among adult patients reported to the Acute Leukemia Working Party between 2000 and 2010. We identified 159 patients with 11q23/MLL rearranged AML allografted in first complete remission (CR1, n=138) or CR2, mostly corresponding to t(9;11), t(11;19), t(6;11) and t(10;11) translocations. Two-year overall survival (OS), leukemia-free survival (LFS), relapse incidence and non-relapse mortality were 56±4%, 51±4%, 31±3% and 17±4%, respectively. The outcome differed according to 11q23/MLL rearrangement, being more favorable in patients with t(9;11) and t(11;19) compared with t(10;11) and t(6;11) (2-year OS: 64±6% and 73±10% vs 40±13% and 24±11%, respectively; P<0.0001). Multivariate analysis for OS identified t(6;11), t(10;11), age>40 years and CR2 as unfavorable features, whereas t(6;11), t(10;11), CR2 and the use of reduced-intensity conditioning regimen affected poorly the LFS. This study confirms the potential role of alloHSCT for adult patients with 11q23/MLL rearranged AML in CR1.
authors.affiliation: Department of Hematology, CHU de Bordeaux, Bordeaux, France.|Hématopoïèses Leucémique et Cible Thérapeutique, INSERM U 1035, Université Bordeaux Segalen, Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Pigneux
authors.affiliation: Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.|ALWP EBMT, Hôpital Saint Antoine, Paris, France.|Universite Pierre et Marie Curie, Paris, France.|INSERM UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Department of Hematology, Acute Leukemia and Stem Cell Transplantation Unit, University Hospitals Leuven Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Maertens
authors.affiliation: Service d'Hématologie and Faculté de Médecine, Hôpital Henri Mondor, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Volin
authors.affiliation: Bone Marrow Transplantation, Saint-Louis Hospital, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Centre for Clinical Haematology, Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, Birmingham, UK.
authors.forename: C
authors.initials: C
authors.lastname: Craddock
authors.affiliation: Department of Hematology, CHU de Bordeaux, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.affiliation: MLL Munich Leukemia Laboratory, Munich, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Bacher
authors.affiliation: Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.|ALWP EBMT, Hôpital Saint Antoine, Paris, France.|Universite Pierre et Marie Curie, Paris, France.|INSERM UMRs 938, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Malard
authors.affiliation: Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Esteve
authors.affiliation: ALWP EBMT, Hôpital Saint Antoine, Paris, France.|Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.|ALWP EBMT, Hôpital Saint Antoine, Paris, France.|Universite Pierre et Marie Curie, Paris, France.|INSERM UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D002880:Chromosomes, Human, Pair 11; D005260:Female; D015321:Gene Rearrangement; D018380:Hematopoietic Stem Cell Transplantation; D011495:Histone-Lysine N-Methyltransferase / Q000235:genetics*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics*; D012008:Recurrence; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase