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Non-inferior long-term outcomes of adults with Philadelphia chromosome-like acute lymphoblastic leukemia

Bone Marrow Transplantation volume 56, pages 1953–1963 (2021)Cite this article

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Abstract

Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is associated with inferior outcomes in the chemotherapy setting. We hypothesized that allogeneic hematopoietic cell transplantation (allo-HCT)-based post-remission therapy would improve outcomes of this entity. We examined the frequency and long-term outcomes of adults with Ph-like ALL, particularly focusing on allo-HCT outcomes for Ph-like ALL versus non-Ph-like ALL. Ph-like ALL was determined by anchored multiplex PCR-based targeted next-generation sequencing. Of the 344 patients, 57 (16.6%) had Ph-like ALL, 197 (57.3%) had Ph-positive ALL, and 90 (26.1%) had B-other ALL. To further evaluate the prognosis of Ph-like ALL, outcome analyses were restricted to 147 patients, excluding Ph-positive ALL. The actual allo-HCT rates in complete remission were 87.7% for Ph-like ALL, 71.4% for B-other standard-risk ALL, and 70.4% for B-other poor-risk ALL. Patients with Ph-like ALL had a higher 5-year overall survival (60.6% vs 27.1%; P = 0.008) than B-other poor-risk ALL subgroup, while no difference was observed compared with B-other standard-risk ALL subgroup. Similar results were noted in a separate analysis for patients receiving allo-HCT in complete remission. In multivariate analyses, B-other poor-risk ALL was associated with poorer outcomes. Our data showed that allo-HCT-based post-remission therapy may have contributed to non-inferior outcomes of adult Ph-like ALL.

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Fig. 1: Flow chart of the patients included in this study.
Fig. 2: Outcomes of all patients according to disease subtype.
Fig. 3: Genetic alterations identified in patients.
Fig. 4: Outcomes between different genetic subgroups in Ph-like ALL.

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Acknowledgements

This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03029283) and Research Fund of Seoul St. Mary’s Hospital, The Catholic University of Korea (ZC17SISI0412).

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  1. These authors contributed equally: Hanwool Cho, Yonggoo Kim, Jae-Ho Yoon, Seok Lee, Myungshin Kim

Authors and Affiliations

  1. Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Hanwool Cho, Yonggoo Kim, Jaewoong Lee, Kyungja Han & Myungshin Kim

  2. Catholic Genetic Laboratory Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Yonggoo Kim, Jaewoong Lee, Gun Dong Lee, Jungok Son & Myungshin Kim

  3. Department of Hematology, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jae-Ho Yoon & Seok Lee

  4. Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jae-Ho Yoon & Seok Lee

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Cho, H., Kim, Y., Yoon, JH. et al. Non-inferior long-term outcomes of adults with Philadelphia chromosome-like acute lymphoblastic leukemia. Bone Marrow Transplant 56, 1953–1963 (2021). https://doi.org/10.1038/s41409-021-01253-6

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