Efficacy of myeloablative allogeneic hematopoietic stem cell transplantation in adult patients with MLL-ELL-positive acute myeloid leukemia View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-11

AUTHORS

Tomoya Muto, Masahiro Takeuchi, Atsuko Yamazaki, Yasumasa Sugita, Shokichi Tsukamoto, Shio Sakai, Yusuke Takeda, Naoya Mimura, Chikako Ohwada, Emiko Sakaida, Nobuyuki Aotsuka, Tohru Iseki, Chiaki Nakaseko

ABSTRACT

Acute myeloid leukemia (AML) with mixed lineage leukemia-eleven-nineteen lysine-rich leukemia (MLL-ELL) is a rare subtype of MLL-rearranged AML. The outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with this disease remains unknown. In the present study, we retrospectively investigated the efficacy of allo-HSCT in eight adult MLL-ELL-positive AML patients. Although all eight patients achieved first complete remission (CR1), three (37.5 %) patients experienced relapse after induction therapy. Five (62.5 %) patients underwent allo-HSCT during CR1, whereas two (25.0 %) underwent allo-HSCT during disease relapse, and one (12.5 %) during CR2. All three patients who received allo-HSCT beyond CR1 died due to AML progression after allo-HSCT. Of the five patients who received allo-HSCT during CR1, three (60.0 %) remained alive at study conclusion. The overall survival rate at five years was 50.0 %. Intriguingly, clonally expanded non-leukemic cells expressing MLL-ELL during consolidation therapy were found to be eradicated after allo-HSCT during the monitoring of minimal residual disease in one patient; this indicates that allo-HSCT is efficacious for eliminating pre-leukemic cells resistant to chemotherapy. In conclusion, allo-HSCT soon after CR1 represents a promising therapeutic option for adult AML patients with MLL-ELL, although the outcome of allo-HSCT for patients beyond CR1 was dismal. More... »

PAGES

86-92

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12185-015-1779-z

DOI

http://dx.doi.org/10.1007/s12185-015-1779-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016907991

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25758097


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33 schema:description Acute myeloid leukemia (AML) with mixed lineage leukemia-eleven-nineteen lysine-rich leukemia (MLL-ELL) is a rare subtype of MLL-rearranged AML. The outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with this disease remains unknown. In the present study, we retrospectively investigated the efficacy of allo-HSCT in eight adult MLL-ELL-positive AML patients. Although all eight patients achieved first complete remission (CR1), three (37.5 %) patients experienced relapse after induction therapy. Five (62.5 %) patients underwent allo-HSCT during CR1, whereas two (25.0 %) underwent allo-HSCT during disease relapse, and one (12.5 %) during CR2. All three patients who received allo-HSCT beyond CR1 died due to AML progression after allo-HSCT. Of the five patients who received allo-HSCT during CR1, three (60.0 %) remained alive at study conclusion. The overall survival rate at five years was 50.0 %. Intriguingly, clonally expanded non-leukemic cells expressing MLL-ELL during consolidation therapy were found to be eradicated after allo-HSCT during the monitoring of minimal residual disease in one patient; this indicates that allo-HSCT is efficacious for eliminating pre-leukemic cells resistant to chemotherapy. In conclusion, allo-HSCT soon after CR1 represents a promising therapeutic option for adult AML patients with MLL-ELL, although the outcome of allo-HSCT for patients beyond CR1 was dismal.
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40 AML progression
41 CR1
42 CR2
43 MLL
44 MLL-ELL
45 acute myeloid leukemia
46 adult AML patients
47 adult patients
48 allo-HSCT
49 allogeneic hematopoietic stem cell transplantation
50 cell transplantation
51 cells
52 chemotherapy
53 complete remission
54 conclusion
55 consolidation therapy
56 disease
57 disease relapse
58 efficacy
59 first complete remission
60 hematopoietic stem cell transplantation
61 induction therapy
62 leukemia
63 lysine-rich leukemia
64 minimal residual disease
65 monitoring
66 myeloablative allogeneic hematopoietic stem cell transplantation
67 myeloid leukemia
68 non-leukemic cells
69 options
70 outcomes
71 overall survival rate
72 patients
73 positive AML patients
74 positive acute myeloid leukemia
75 pre-leukemic cells
76 present study
77 progression
78 promising therapeutic option
79 rare subtype
80 rate
81 relapse
82 remission
83 residual disease
84 stem cell transplantation
85 study
86 study conclusions
87 subtypes
88 survival rate
89 therapeutic options
90 therapy
91 transplantation
92 underwent allo-HSCT
93 years
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