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Prognostic impact of cytogenetic abnormalities in adult patients with Philadelphia chromosome-negative ALL who underwent an allogeneic transplant

Bone Marrow Transplantation volume 54, pages 2020–2026 (2019)Cite this article

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Abstract

Although cytogenetic abnormalities at diagnosis are recognized as an important prognostic factor in patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL), the prognostic impact has not been evaluated in allogeneic stem cell transplant (allo-SCT) recipients. Thus, we assessed 373 Ph-negative ALL patients who underwent allo-SCT. The high-risk (HR) group included those with t(4;11), t(8;14), low hypodiploidy, and complex karyotype, and the standard risk (SR) group included all other karyotypes. Among the 204 patients who underwent a transplant during the first remission (167 in the SR group and 37 in the HR group), the overall survival (OS) rates were similar between these groups (64.1% vs. 80.0% at 5 years, respectively; p = 0.12). Conversely, among the 106 patients who underwent a transplant while not in remission (84 in the SR group and 22 in the HR group), patients in the SR group showed a significantly superior OS rate compared to the HR group (15.4% vs. 4.5% at 5 years, respectively; p = 0.022). These results suggested that treatment outcomes of Ph-negative ALL patients with HR cytogenetic abnormalities may improve following allo-SCT, especially in the first remission. Innovative transplant approaches are warranted in patients who are not in remission.

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Acknowledgements

We wish to thank all of the staff in the participating institutions of the Kanto Study Group for Cell Therapy.

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Authors and Affiliations

  1. Department of Hematology, Gunma University, Gunma, Japan

    Hiroaki Shimizu

  2. Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  3. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Heiwa Kanamori

  4. Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan

    Toru Sakura

  5. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Takehiko Mori & Shinichiro Okamoto

  6. Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Shinichiro Machida

  7. Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Satoshi Takahashi

  8. Division of Hematology, Department of Clinical Cell Biology, Chiba University Graduate School of Medicine, Chiba, Japan

    Chikako Ohwada

  9. Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan

    Shin Fujisawa

  10. Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

  11. Department of Hematology and Clinical Immunology, Yokohama City University Hospital, Yokohama, Japan

    Maki Hagihara

  12. Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  13. Department of Internal Medicine, Chiba Aoba Municipal Hospital, Chiba, Japan

    Masahiro Onoda

  14. Department of Hematology, Tokyo Medical University, Tokyo, Japan

    Moritaka Gotoh

  15. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Shinichi Kako

  16. Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan

    Jun Taguchi

  17. Division of Hematology, NTT Medical Center Tokyo, Tokyo, Japan

    Kensuke Usuki

  18. Department of Hematology, International Medical Center, Saitama Medical University, Saitama, Japan

    Nobutaka Kawai

  19. Department of Hematology, Narita Red Cross Hospital, Narita, Japan

    Nobuyuki Aotsuka

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  1. Hiroaki Shimizu
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for the Kanto Study Group for Cell Therapy (KSGCT)

Contributions

HS designed and performed the research, analyzed the data, and wrote the manuscript; ND, HK, TS, TM, SM, ST, CO, SF, SY, MH, YK, MO, MG, SK, JT, KU, NK, NA, and SO provided the patient data, reviewed, and confirmed the manuscript.

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Correspondence to Hiroaki Shimizu.

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Shimizu, H., Doki, N., Kanamori, H. et al. Prognostic impact of cytogenetic abnormalities in adult patients with Philadelphia chromosome-negative ALL who underwent an allogeneic transplant. Bone Marrow Transplant 54, 2020–2026 (2019). https://doi.org/10.1038/s41409-019-0585-2

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