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September 15, 2021Blood AdvancesOpen Access

Outcomes of acute lymphoblastic leukemia with KMT2A (MLL) rearrangement: the MD Anderson experience

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Authors

GRGuillaume Richard‐CarpentierHKHagop M. KantarjianGTGuilin Tang

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Overview

Retrospective cohort reveals low long-term survival in adult KMT2A-rearranged ALL, highlighting the potential therapeutic role of stem cell transplantation.

Key Points

  • To evaluate the clinical outcomes of adult acute lymphoblastic leukemia (ALL) with various KMT2A rearrangements and assess the potential benefit of allogeneic stem cell transplantation (HSCT).
  • Retrospective review of N=50 adult ALL patients with KMT2A rearrangements out of 1102 patients treated at a single center between 1984 and 2019.
  • Patients had a median age of 45 years (range, 18-78) and included 42 (84%) with t(4;11)/KMT2A-AFF1 and 8 (16%) with other translocation partner genes.
  • Outcomes evaluated included complete remission (CR), measurable residual disease (MRD) negativity, and 5-year overall survival (OS) analyzed by rearrangement subtype and HSCT landmark analysis.
  • The complete remission rate was 88%, with 41% achieving measurable residual disease negativity at CR (76% overall during follow-up).
  • The overall 5-year OS rate was 18% (95% CI, 9% to 35%), showing no statistically significant difference between t(4;11) and other KMT2A rearrangements (P = .87).
  • In a 4-month landmark analysis, the 5-year OS was 32% (95% CI, 14% to 70%) among patients who received HSCT versus 11% (95% CI, 3% to 39%) without HSCT (P = .10).

Cite This Study

Richard‐Carpentier et al. (2021) studied this question.

synapsesocial.com/papers/69d7e5967392c8ce61bee29fhttps://doi.org/10.1182/bloodadvances.2021004580
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