Abstract
Acute myeloid leukemia (AML) with t(6;9)(p23;q34) is well known to have a poor prognosis treated with chemotherapy and autotransplantation. The presence of this karyotype is an indicator for allogeneic hematopoietic stem cell transplantation (HSCT); however, the impact of t(6;9)(p23;q34) on the HSCT outcome remains unclear. We conducted a matched-pair analysis of de novo AML patients with and without t(6;9)(p23;q34) using data obtained from the Japanese HSCT data registry. A total of 57 patients with t(6;9)(p23;q34) received transplants between 1996 and 2007, and 171 of 2056 normal karyotype patients matched for age, disease status at HSCT and graft source were selected. The overall survival, disease-free survival, cumulative incidence of relapse and the non-relapse mortality in t(6;9)(p23;q34) patients were comparable to those for normal karyotype patients. A univariate analysis showed that t(6;9)(p23;q34) had no significant impact on the overall survival. These findings suggest that allogeneic HSCT may overcome the unfavorable impact of t(6;9)(p23;q34) as an independent prognostic factor.
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References
Ishikawa F, Yoshida S, Saito Y, Hijikata A, Kitamura H, Tanaka S et al. Chemotherapy-resistant human AML stem cells home to and engraft within the bone-marrow endosteal region. Nat Biotechnol 2007; 25: 1315–1321.
Zittoun RA, Mandelli F, Willemze R, de Witte T, Labar B, Resegotti L et al. European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell’Adulto (GIMEMA) Leukemia Cooperative Groups. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med 1995; 332: 217–223.
Yanada M, Matsuo K, Emi N, Naoe T . Efficacy of allogeneic hematopoietic stem cell transplantation depends on cytogenetic risk for acute myeloid leukemia in first disease remission: a metaanalysis. Cancer 2005; 103: 1652–1658.
Suciu S, Mandelli F, de Witte T, Zittoun R, Gallo E, Labar B et al. Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trial. Blood 2003; 102: 1232–1240.
Kurosawa S, Yamaguchi T, Miyawaki S, Uchida N, Kanamori H, Usuki K et al. A Markov decision analysis of allogeneic hematopoietic cell transplantation versus chemotherapy in patients with acute myeloid leukemia in first remission. Blood 2011; 117: 2113–2120.
The Medical Research Council Adult and Children's Leukaemia Working Parties Grimwade D Walker H Oliver F Wheatley K Harrison C, Harrison G et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. Blood 1998; 92: 2322–2333.
Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96: 4075–4083.
van der Straaten HM, van Biezen A, Brand R, Schattenberg AV, Egeler RM, Barge RM et al. Allogeneic stem cell transplantation for patients with acute myeloid leukemia or myelodysplastic syndrome who have chromosome 5 and/or 7 abnormalities. Haematologica 2005; 90: 1339–1345.
Slovak ML, Gundacker H, Bloomfield CD, Dewald G, Appelbaum FR, Larson RA et al. A retrospective study of 69 patients with t(6;9)(p23;q34) AML emphasizes the need for a prospective, multicenter initiative for rare ‘poor prognosis’ myeloid malignancies. Leukemia 2006; 20: 1295–1297.
Garcon L, Libura M, Delabesse E, Valensi F, Asnafi V, Berger C et al. DEK-CAN molecular monitoring of myeloid malignancies could aid therapeutic stratification. Leukemia 2005; 19: 1338–1344.
Gooley TA, Leisenring W, Crowley J, Storer BE . Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 1999; 18: 695–706.
Gupta M, Ashok Kumar J, Sitaram U, Neeraj S, Nancy A, Balasubramanian P et al. The t(6;9)(p22;q34) in myeloid neoplasms: a retrospective study of 16 cases. Cancer Genet Cytogenet 2010; 203: 297–302.
Esteve J, Labopin M, Socie G, Ljungman PT, Maertens J, Schattenberg AV et al. Allogeneic hematopoietic stem-cell transplantation in early phase might overcome the adverse prognosis of acute myeloid leukemia with translocation t(6;9)(p23;q34)/DEK-NUP214(CAN) rearrangement. A retrospective analysis from the acute leukemia working party of EBMT. Blood 2010; 116: 1438 (Abstract 3501).
Acknowledgements
We are indebted to all the patients and the staff of the participating institutions of the Japan Society for Hematopoietic Cell Transplantation, the Japan Marrow Donor Program, The Japanese Cord Blood Bank Network and The Japanese Society of Pediatric Hematology. We would like to thank Takako Sakai, data manager of the Japan Society for Hematopoietic Cell Transplantation Data Registry, for her excellent assistance.
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Ishiyama, K., Takami, A., Kanda, Y. et al. Allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia with t(6;9)(p23;q34) dramatically improves the patient prognosis: a matched-pair analysis. Leukemia 26, 461–464 (2012). https://doi.org/10.1038/leu.2011.229
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DOI: https://doi.org/10.1038/leu.2011.229
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