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OUTCOME OF ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN A MIXED COHORT OF PEDIATRIC AND ADULT PATIENTS WITH KMT2A-AFF1 ACUTE LYMPHOBLASTIC LEUKEMIA
Author(s):
Tatiana L Gindina
,
Tatiana L Gindina
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Nikolay Mamaev
,
Nikolay Mamaev
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Olesya Paina
,
Olesya Paina
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Olga Pirogova
,
Olga Pirogova
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Olga Slesarchuk
,
Olga Slesarchuk
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Yana Gudozhnikova
,
Yana Gudozhnikova
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Alexander Alyanskiy
,
Alexander Alyanskiy
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Sergey Bondarenko
,
Sergey Bondarenko
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Lyudmila Zubarovskaya
,
Lyudmila Zubarovskaya
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
Boris Afanasyev
Boris Afanasyev
Affiliations:
R.M. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Department of Hematology, Transfusiology and Transplantation,1st Pavlov State Medical University of Saint Petersburg,Saint-Petersburg,Russian Federation
(Abstract release date: 05/18/17) EHA Library. Gindina T. 05/18/17; 182359; PB1645
Dr. Tatiana Gindina
Dr. Tatiana Gindina
Contributions
PDF Abstract
Abstract

Abstract: PB1645

Type: Publication Only

Background

Acute lymphoblastic leukemia with poor-risk translocation t(4;11)(q21;q23)/KMT2A-AFF1 occurs in all age groups with a clear dominance in children, especially up to 1 year. To date, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered to be potentially curative treatment in high-risk acute leukemia patients, including the abovementioned.

Aims
To evaluate the prognostic impact of the different clinical and cytogenetic characteristics on the results of allogeneic hematopoietic stem cell transplantation in KMT2A-AFF1 acute lymphoblastic leukemia patients.

Methods
Retrospective analysis of treatment results was performed for a mixed cohort of the patients with KMT2A-AFF1 ALL who received allo-HSCT, including haploidentical one at our University over 2008 to 2015. Twenty-one patients (12 females and 9 males aged from 3 months to 48 years; median 18.9 years) were examined.

Results

Eight of 21 (38 %) patients exhibited an isolated t(4;11) translocation. Additional chromosome abnormalities (ACA) were revealed in 11 (52%) patients, including 8 (42%) subjects with 3 and more chromosome aberrations. In univariate analysis, significance was shown for clinical stage at HSCT (1st remission vs other stages, 75% vs 0% p=<0,001 for OS; 58% vs 0%, p=<0,001 for EFS), complex chromosomal aberrations (<3 abnormalities vs ≥3 abnormalities, 58% vs 13%, p=0.04 for OS; 46% vs 0%, p=0.04 for EFS). According to multivariate analysis, the clinical stage at HSCT (HR 26.8, 95% CI 3.28-218.80; р=0.002 for OS; HR 11.18, 95% CI 2.92-42.80 p=0,0004 for EFS) was only independent prognostic factor for clinical outcomes.

Conclusion

The study has shown the stage of disease at the moment of allo-HSCT to be independent prognostic factor in a mixed cohort of KMT2A-AFF1 ALL patients treated with HSCT. The good results of allo-HSCT can be obtained using a haploidentical transplantation from parents that removes the problem of searching the HLA-matched donors in the Registers and, therefore, greatly simplifies the treatment.

Session topic: 2. Acute lymphoblastic leukemia - Clinical

Keyword(s): MLL, Allogeneic hematopoietic stem cell transplant, ALL

Abstract: PB1645

Type: Publication Only

Background

Acute lymphoblastic leukemia with poor-risk translocation t(4;11)(q21;q23)/KMT2A-AFF1 occurs in all age groups with a clear dominance in children, especially up to 1 year. To date, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered to be potentially curative treatment in high-risk acute leukemia patients, including the abovementioned.

Aims
To evaluate the prognostic impact of the different clinical and cytogenetic characteristics on the results of allogeneic hematopoietic stem cell transplantation in KMT2A-AFF1 acute lymphoblastic leukemia patients.

Methods
Retrospective analysis of treatment results was performed for a mixed cohort of the patients with KMT2A-AFF1 ALL who received allo-HSCT, including haploidentical one at our University over 2008 to 2015. Twenty-one patients (12 females and 9 males aged from 3 months to 48 years; median 18.9 years) were examined.

Results

Eight of 21 (38 %) patients exhibited an isolated t(4;11) translocation. Additional chromosome abnormalities (ACA) were revealed in 11 (52%) patients, including 8 (42%) subjects with 3 and more chromosome aberrations. In univariate analysis, significance was shown for clinical stage at HSCT (1st remission vs other stages, 75% vs 0% p=<0,001 for OS; 58% vs 0%, p=<0,001 for EFS), complex chromosomal aberrations (<3 abnormalities vs ≥3 abnormalities, 58% vs 13%, p=0.04 for OS; 46% vs 0%, p=0.04 for EFS). According to multivariate analysis, the clinical stage at HSCT (HR 26.8, 95% CI 3.28-218.80; р=0.002 for OS; HR 11.18, 95% CI 2.92-42.80 p=0,0004 for EFS) was only independent prognostic factor for clinical outcomes.

Conclusion

The study has shown the stage of disease at the moment of allo-HSCT to be independent prognostic factor in a mixed cohort of KMT2A-AFF1 ALL patients treated with HSCT. The good results of allo-HSCT can be obtained using a haploidentical transplantation from parents that removes the problem of searching the HLA-matched donors in the Registers and, therefore, greatly simplifies the treatment.

Session topic: 2. Acute lymphoblastic leukemia - Clinical

Keyword(s): MLL, Allogeneic hematopoietic stem cell transplant, ALL

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