TY - JOUR
T1 - Outcomes of acute lymphoblastic leukemia with KMT2A (MLL) rearrangement
T2 - The MD Anderson experience
AU - Richard-Carpentier, Guillaume
AU - Kantarjian, Hagop M.
AU - Tang, Guilin
AU - Yin, C. Cameron
AU - Khoury, Joseph
AU - Issa, Ghayas C.
AU - Haddad, Fadi
AU - Jain, Nitin
AU - Ravandi, Farhad
AU - Short, Nicholas J.
AU - DiNardo, Courtney D.
AU - Takahashi, Koichi
AU - Konopleva, Marina
AU - Daver, Naval G.
AU - Kadia, Tapan
AU - Garcia-Manero, Guillermo
AU - Garris, Rebecca
AU - O’Brien, Susan
AU - Jabbour, Elias
N1 - Funding Information:
and Amgen. C.D.D. received research grants and consulting fees from AbbVie and Celgene; received consulting fees from Agios, Jazz, Syros and Daiichi-Sankyo; and attended a scientific advisory board for Notable Labs. K.T. received consulting fees from Glaxo-Smith-Kline, Symbio Pharmaceuticals, and Celgene and received honoraria from Dava Oncology. M.Y.K. received research grants and consulting fees from AbbVie, Genentech, F. Hoffman La-Roche, and Stemline Therapeutics; received consulting fees from Amgen, Forty-Seven, and Kisoji; received research grants from Eli Lilly, Cellectis, Calithera, Ablynx, Agios, Ascentage, and Astra Zeneca; received stock options from Reata Pharmaceutical and Kisoji; and received royalties from Reata Pharmaceuticals. N.G.D. received research grants, consulting fees, and honoraria from Pfizer, Bristol Myers Squibb, Novartis, Incyte, Immunogen, Astellas, and AbbVie; received research grants and consulting fees from Daiichi-Sankyo, Karyopharm, and Sunesis;
Funding Information:
Conflict-of-interest disclosure: G.R.-C. received consulting fees from Astellas and Taiho Pharma. H.M.K. received research grants and honoraria from AbbVie, Agios, Amgen, Immunogen, and Pfizer; received research grants from Ariad, Astex, Bristol Myers Squibb, Cyclacel, Daiichy-Sankyo, Jazz Pharma, and Novartis; received honoraria from Takeda; and attended an advisory board for Actinium. G.C.I. received research funding from Celgene, Kura Oncology, Syndax, and Novartis; served on an advisory board for Novartis; and received consulting fees from Kura Oncology. N.J. received research grants and consulting fees from Servier, Pharmacyclics, AstraZeneca, Genentech, Verastem, Pfizer, AbbVie, ADC Therapeutics, Precision Biosciences, and Adaptive Biotechnologies; received research grants from Bristol Myers Squibb, Celgene, Seattle Genetics, and Incyte; and received consulting fees from Janssen. N.J.S. received research grants from Takeda and Astellas and consulting fees from Takeda, AstraZeneca,
Publisher Copyright:
© 2021 by The American Society of Hematology.
PY - 2021/12/14
Y1 - 2021/12/14
N2 - Acute lymphoblastic leukemia (ALL) with t(4;11)(q21;q23)-KMT2A-AFF1 is associated with a poor prognosis. The impact of KMT2A rearrangements other than t(4;11) is uncertain, and the benefit of allogeneic stem cell transplantation (HSCT) is unclear. We reviewed adult patients with ALL treated at our institution from 1984 to 2019 and identified 50 out of 1102 (5%) with KMT2A rearrangement, including 42 (84%) with t(4;11)/KMT2A-AFF1 and 8 (16%) with other gene partners. The median age was 45 years (range, 18-78 years); median white blood cell count was 109.0 3 109/L (range, 0.5-1573.0). The complete remission (CR) rate was 88%, and the rate of measurable residual disease negativity by flow cytometry at CR was 41% (76% overall during follow-up). At the last follow-up, 14 patients were alive. The 5-year overall survival (OS) rate was 18% (95% confidence interval [CI], 9% to 35%), with no difference between t(4;11) and other KMT2A rearrangements (P 5 .87). In a 4-month landmark analysis, the 5-year OS rate was 32% (95% CI, 14% to 70%) in patients who underwent HSCT vs 11% (95% CI, 3-39) in others (P 5 .10). Our study confirms the poor prognosis of ALL with any KMT2A rearrangement and the role of HSCT in these patients.
AB - Acute lymphoblastic leukemia (ALL) with t(4;11)(q21;q23)-KMT2A-AFF1 is associated with a poor prognosis. The impact of KMT2A rearrangements other than t(4;11) is uncertain, and the benefit of allogeneic stem cell transplantation (HSCT) is unclear. We reviewed adult patients with ALL treated at our institution from 1984 to 2019 and identified 50 out of 1102 (5%) with KMT2A rearrangement, including 42 (84%) with t(4;11)/KMT2A-AFF1 and 8 (16%) with other gene partners. The median age was 45 years (range, 18-78 years); median white blood cell count was 109.0 3 109/L (range, 0.5-1573.0). The complete remission (CR) rate was 88%, and the rate of measurable residual disease negativity by flow cytometry at CR was 41% (76% overall during follow-up). At the last follow-up, 14 patients were alive. The 5-year overall survival (OS) rate was 18% (95% confidence interval [CI], 9% to 35%), with no difference between t(4;11) and other KMT2A rearrangements (P 5 .87). In a 4-month landmark analysis, the 5-year OS rate was 32% (95% CI, 14% to 70%) in patients who underwent HSCT vs 11% (95% CI, 3-39) in others (P 5 .10). Our study confirms the poor prognosis of ALL with any KMT2A rearrangement and the role of HSCT in these patients.
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U2 - 10.1182/bloodadvances.2021004580
DO - 10.1182/bloodadvances.2021004580
M3 - Article
C2 - 34525185
AN - SCOPUS:85122139243
SN - 2473-9529
VL - 5
SP - 5415
EP - 5419
JO - Blood Advances
JF - Blood Advances
IS - 23
ER -