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Ikaros family zinc-finger 1 mutation is an independent factor for the poor prognosis of adult B-cell acute lymphoblastic leukemia, and allogeneic hematopoietic stem cell transplantation can improve clinical outcomes

Bone Marrow Transplantation volume 54, pages 236–243 (2019)Cite this article

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Abstract

To investigate the prognosis of patients with adult B-cell acute lymphoblastic leukemia (B-ALL) with Ikaros family zinc-finger 1 (IKZF1) mutation and determine the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in improving the clinical outcome, we detected the IKZF1 mutation and BCR-ABL fusion gene at diagnosis in the bone marrow of 164 adult patients with B-ALL, and analyzed the clinical data of these patients retrospectively. Our analysis showed that grade III–IV acute graft-versus-host disease and IKZF1 mutation in the transplantation group and age and IKZF1 mutation in the non-transplantation group were independent factors for poor prognosis by univariate and multivariate analyses.The 3-year overall survival (OS) and leukemia-free survival (LFS) rates were much lower in the IKZF1+/BCR-ABL+ subgroup than in the IKZF1+/BCR-ABL− and IKZF1−/BCR-ABL− subgroups in both the transplantation and non-transplantation groups. The 3-year OS and LFS rates were significantly higher in the transplantation group than in the non-transplantation group with IKZF1 mutation.The study demonstrated that IKZF1 mutation was an independent factor indicating the poor prognosis of adult B-ALL and much worse prognosis in the BCR-ABL+ subgroup in both non-transplantation and transplantation groups. However, allo-HSCT significantly improved the OS and LFS of patients and also their clinical outcomes.

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Acknowledgements

This study was supported in part by research grants from the National Key R&D Program of China (2016YFC0902800), the National Natural Science Foundation of China (81270645), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), the Frontier Clinical Technical Project of the Science and Technology Department of Jiangsu Province (BE2017655), and the Jiangsu Provincial Medical Talent (ZDRCA2016045).

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Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou, China

    Tang Shanhao, Shen Hongjie, Qu Changju, Dai Haiping, Zhu Xiaming, Xue Shengli, Ding Zixuan, Lu Jing, Wu Depei & Tang Xiaowen

  2. Department of Hematology, Yinzhou People Hospital, Ningbo, China

    Tang Shanhao

  3. Institute of Blood and Marrow Transplantation, Suzhou, China

    Shen Hongjie, Qu Changju, Dai Haiping, Zhu Xiaming, Xue Shengli, Ding Zixuan, Lu Jing, Wu Depei & Tang Xiaowen

  4. Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China

    Shen Hongjie, Qu Changju, Dai Haiping, Zhu Xiaming, Xue Shengli, Ding Zixuan, Lu Jing, Wu Depei & Tang Xiaowen

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  1. Tang Shanhao
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Correspondence to Wu Depei or Tang Xiaowen.

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Tang, S., Shen, H., Qu, C. et al. Ikaros family zinc-finger 1 mutation is an independent factor for the poor prognosis of adult B-cell acute lymphoblastic leukemia, and allogeneic hematopoietic stem cell transplantation can improve clinical outcomes. Bone Marrow Transplant 54, 236–243 (2019). https://doi.org/10.1038/s41409-018-0249-7

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