Long-term disease-free survivors with cytogenetically normal acute myeloid leukemia and MLL partial tandem duplication: a Cancer and Leukemia Group B study

SP Whitman, AS Ruppert, G Marcucci… - Blood, The Journal …, 2007 - ashpublications.org
SP Whitman, AS Ruppert, G Marcucci, K Mrózek, P Paschka, C Langer, CD Baldus, J Wen…
Blood, The Journal of the American Society of Hematology, 2007ashpublications.org
The clinical impact of MLL partial tandem duplication (MLL-PTD) was evaluated in 238
adults aged 18 to 59 years with cytogenetically normal (CN) de novo acute myeloid
leukemia (AML) who were treated intensively on similar Cancer and Leukemia Group B
protocols 9621 and 19808. Twenty-four (10.1%) patients harbored an MLL-PTD. Of those,
92% achieved complete remission (CR) compared with 83% of patients without MLL-PTD
(P=. 39). Neither overall survival nor disease-free survival significantly differed between the …
Abstract
The clinical impact of MLL partial tandem duplication (MLL-PTD) was evaluated in 238 adults aged 18 to 59 years with cytogenetically normal (CN) de novo acute myeloid leukemia (AML) who were treated intensively on similar Cancer and Leukemia Group B protocols 9621 and 19808. Twenty-four (10.1%) patients harbored an MLL-PTD. Of those, 92% achieved complete remission (CR) compared with 83% of patients without MLL-PTD (P = .39). Neither overall survival nor disease-free survival significantly differed between the 2 groups (P = .67 and P = .55, respectively). Thirteen MLL-PTD+ patients relapsed within 1.4 years of achieving CR. MLL-PTD+ patients who relapsed more often had other adverse CN-AML–associated molecular markers. In contrast with previously reported studies, 9 (41%) MLL-PTD+ patients continue in long-term first remission (CR1; range, 2.5-7.7 years). Intensive consolidation therapy that included autologous peripheral stem-cell transplantation during CR1 may have contributed to the better outcome of this historically poor-prognosis group of CN-AML patients with MLL-PTD.
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