The clinical characteristics, therapy and outcome of 85 adults with acute lymphoblastic leukemia and t(4;11)(q21;q23)/MLL-AFF1 prospectively treated in the UKALLXII/ECOG2993 trial

David I. Marks*, Anthony V. Moorman, Lucy Chilton, Elisabeth Paietta, Amir Enshaie, Gordon DeWald, Christine J. Harrison, Adele K. Fielding, Letizia Foroni, Anthony H. Goldstone, Mark R. Litzow, Selina M. Luger, Andrew K. McMillan, Janis Racevskis, Jacob M. Rowe, Martin S. Tallman, Peter Wiernik, Hillard M. Lazarus

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

32 Citations (Scopus)

Abstract

The biology and outcome of adult t(4;11)(q21;q23)/MLL-AFF1 acute lymphoblastic leukemia are poorly understood. We describe the outcome and delineate prognostic factors and optimal post-remission therapy in 85 consecutive patients (median age 38 years) treated uniformly in the prospective trial UKALLXII/ECOG2993. The immunophenotype of this leukemia was pro-B (CD10(NEG)). Immaturity was further suggested by high expression of the stem-cell antigens, CD133 and CD135, although CD34 expression was significantly lower than in t(4; 11)negative patients. Complete remission was achieved in 77 (93%) patients but only 35% survived 5 years (95% CI: 25-45%); the relapse rate was 45% (95% CI: 33-58%). Thirty-one patients underwent allogeneic transplantation in first remission (15 sibling donors and 16 unrelated donors): with 5-year survival rates of 56% and 67% respectively, only 2/31 patients relapsed. This compares with a 24% survival rate and 59% relapse rate in 46 patients who received post-remission chemotherapy. A major determinant of outcome was age with 71% of patients aged

Original languageEnglish
Pages (from-to)945-952
Number of pages8
JournalHaematologica
Volume98
Issue number6
DOIs
Publication statusPublished - Jun 2013

Keywords

  • MINIMAL-RESIDUAL-DISEASE
  • GENE REARRANGEMENTS
  • COMPLETE REMISSION
  • REDUCED-INTENSITY
  • TRANSPLANTATION
  • EXPRESSION
  • TRANSLOCATIONS
  • ABNORMALITIES
  • CHEMOTHERAPY
  • CHILDHOOD

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