GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION.
Background and Objectives: Acute lymphoblastic leukaemia (ALL) carrying t(9;22) or t(4;11) genetic abnormalities represents a very high risk subtype of disease (VHR-ALL). Hematopoietic stem cell transplantation (HSCT) still remains the only curative option also in the Imatinib era. In the last years...
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PAGEPress Publications
2015-05-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/2307 |
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| author | Matteo Parma Clara Vigano' Monica Fumagalli Federica Colnaghi Arianna Colombo Federica Mottadelli Vincenzo Rossi Elena Elli Elisabetta Terruzzi Angelo Belotti Giovanni Cazzaniga Enrico Maria Pogliani Pietro Pioltelli |
| author_facet | Matteo Parma Clara Vigano' Monica Fumagalli Federica Colnaghi Arianna Colombo Federica Mottadelli Vincenzo Rossi Elena Elli Elisabetta Terruzzi Angelo Belotti Giovanni Cazzaniga Enrico Maria Pogliani Pietro Pioltelli |
| author_sort | Matteo Parma |
| collection | DOAJ |
| description | Background and Objectives: Acute lymphoblastic leukaemia (ALL) carrying t(9;22) or t(4;11) genetic abnormalities represents a very high risk subtype of disease (VHR-ALL). Hematopoietic stem cell transplantation (HSCT) still remains the only curative option also in the Imatinib era. In the last years low molecular level of minimal residual disease (MRD) before HSCT was reported as one of the best favourable indexes for survival in ALL. Here we observed that even these patients can show a favourable outcome, if submitted to HSCT with very low MRD. Methods: We considered 18 consecutive VHR-ALL patients eligible to HSCT. 16 of them were transplanted upon first remission, as soon as possible, employing myelo-ablative conditioning regimens. Molecular MRD has been evaluated before and after HSCT.Results: Immediately before HSCT MRD revealed: complete molecular remission (MRDneg) for 5 patients and a level <1x10-3 for 7 patients; 100 days after HSCT we had: MRDneg for 7 patients and a decrease for all the others after HSCT. After tapering of immunosuppressive drugs, 13 patients reached the MRDneg in a median time of 8 months (range 3-16); Based on intention to treat analysis: 14/18 patients are alive and disease free at the time of analysis, overall survival and event free survival is of 78% and 66% respectively, with an average follow-up of 45 months (range 6-84) since HSCT. Conclusion: Early transplantation with low MRD level seems to be correlated with a favourable outcome also in VHR-ALL |
| format | Article |
| id | doaj-art-af5ecefb6c764378a94c334348a27b1b |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2015-05-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-af5ecefb6c764378a94c334348a27b1b2025-01-02T06:47:30ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062015-05-0171e2015041e201504110.4084/mjhid.2015.0411567GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION.Matteo Parma0Clara Vigano'1Monica Fumagalli2Federica Colnaghi3Arianna Colombo4Federica Mottadelli5Vincenzo Rossi6Elena Elli7Elisabetta Terruzzi8Angelo Belotti9Giovanni Cazzaniga10Enrico Maria Pogliani11Pietro Pioltelli12Division of Hematology and BMT Unit, San Gerardo Hospital, MonzaDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaCentro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, Monza, ItalyCentro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, Monza, ItalyCentro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, Monza, ItalyCentro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, Monza, ItalyDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaCentro Ricerca Tettamanti, Clinica Pediatrica Università di Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, Monza, ItalyDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaDivision of Hematology and BMT Unit, San Gerardo Hospital, MonzaBackground and Objectives: Acute lymphoblastic leukaemia (ALL) carrying t(9;22) or t(4;11) genetic abnormalities represents a very high risk subtype of disease (VHR-ALL). Hematopoietic stem cell transplantation (HSCT) still remains the only curative option also in the Imatinib era. In the last years low molecular level of minimal residual disease (MRD) before HSCT was reported as one of the best favourable indexes for survival in ALL. Here we observed that even these patients can show a favourable outcome, if submitted to HSCT with very low MRD. Methods: We considered 18 consecutive VHR-ALL patients eligible to HSCT. 16 of them were transplanted upon first remission, as soon as possible, employing myelo-ablative conditioning regimens. Molecular MRD has been evaluated before and after HSCT.Results: Immediately before HSCT MRD revealed: complete molecular remission (MRDneg) for 5 patients and a level <1x10-3 for 7 patients; 100 days after HSCT we had: MRDneg for 7 patients and a decrease for all the others after HSCT. After tapering of immunosuppressive drugs, 13 patients reached the MRDneg in a median time of 8 months (range 3-16); Based on intention to treat analysis: 14/18 patients are alive and disease free at the time of analysis, overall survival and event free survival is of 78% and 66% respectively, with an average follow-up of 45 months (range 6-84) since HSCT. Conclusion: Early transplantation with low MRD level seems to be correlated with a favourable outcome also in VHR-ALLhttp://www.mjhid.org/index.php/mjhid/article/view/2307Acute Lymphoblastic LeukemiaBone marrow transplantationMinimal Residual Disease |
| spellingShingle | Matteo Parma Clara Vigano' Monica Fumagalli Federica Colnaghi Arianna Colombo Federica Mottadelli Vincenzo Rossi Elena Elli Elisabetta Terruzzi Angelo Belotti Giovanni Cazzaniga Enrico Maria Pogliani Pietro Pioltelli GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. Mediterranean Journal of Hematology and Infectious Diseases Acute Lymphoblastic Leukemia Bone marrow transplantation Minimal Residual Disease |
| title | GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. |
| title_full | GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. |
| title_fullStr | GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. |
| title_full_unstemmed | GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. |
| title_short | GOOD OUTCOME FOR VERY HIGH RISK ADULT B-CELL ACUTE LYMPHOBLASTIC LEUKAEMIA CARRYING GENETIC ABNORMALITIES t(4;11)(q21;q23) or t(9;22)(q34;q11), IF PROMPTLY SUBMITTED TO ALLOGENEIC TRANSPLANTATION, AFTER OBTAINING A GOOD MOLECULAR REMISSION. |
| title_sort | good outcome for very high risk adult b cell acute lymphoblastic leukaemia carrying genetic abnormalities t 4 11 q21 q23 or t 9 22 q34 q11 if promptly submitted to allogeneic transplantation after obtaining a good molecular remission |
| topic | Acute Lymphoblastic Leukemia Bone marrow transplantation Minimal Residual Disease |
| url | http://www.mjhid.org/index.php/mjhid/article/view/2307 |
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