Novel prognostic subgroups in childhood 11q23/MLL-rearranged acute myeloid leukemia: results of an international retrospective study
Top Cited Papers
Open Access
- 17 September 2009
- journal article
- research article
- Published by American Society of Hematology in Blood
- Vol. 114 (12), 2489-2496
- https://doi.org/10.1182/blood-2009-04-215152
Abstract
Translocations involving chromosome 11q23 frequently occur in pediatric acute myeloid leukemia (AML) and are associated with poor prognosis. In most cases, the MLL gene is involved, and more than 50 translocation partners have been described. Clinical outcome data of the 11q23-rearranged subgroups are scarce because most 11q23 series are too small for meaningful analysis of subgroups, although some studies suggest that patients with t(9;11)(p22;q23) have a more favorable prognosis. We retrospectively collected outcome data of 756 children with 11q23- or MLL-rearranged AML from 11 collaborative groups to identify differences in outcome based on translocation partners. All karyotypes were centrally reviewed before assigning patients to subgroups. The event-free survival of 11q23/MLL-rearranged pediatric AML at 5 years from diagnosis was 44% (± 5%), with large differences across subgroups (11% ± 5% to 92% ± 5%). Multivariate analysis identified the following subgroups as independent prognostic predictors: t(1;11)(q21;q23) (hazard ratio [HR] = 0.1, P = .004); t(6;11)(q27;q23) (HR = 2.2, P < .001); t(10;11)(p12;q23) (HR = 1.5, P = .005); and t(10;11)(p11.2;q23) (HR = 2.5, P = .005). We could not confirm the favorable prognosis of the t(9;11)(p22;q23) subgroup. We identified large differences in outcome within 11q23/MLL-rearranged pediatric AML and novel subgroups based on translocation partners that independently predict clinical outcome. Screening for these translocation partners is needed for accurate treatment stratification at diagnosis.Keywords
This publication has 35 references indexed in Scilit:
- Outcomes in CCG-2961, a Children's Oncology Group Phase 3 Trial for untreated pediatric acute myeloid leukemia: a report from the Children's Oncology GroupBlood, 2008
- Monosomy 7 and deletion 7q in children and adolescents with acute myeloid leukemia: an international retrospective studyBlood, 2007
- Less Toxicity by Optimizing Chemotherapy, but Not by Addition of Granulocyte Colony-Stimulating Factor in Children and Adolescents With Acute Myeloid Leukemia: Results of AML-BFM 98Journal of Clinical Oncology, 2006
- Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children's Oncology GroupBlood, 2006
- Effect of race on outcome of white and black children with acute myeloid leukemia: The St. Jude experiencePediatric Blood & Cancer, 2006
- Pediatric acute myeloid leukemia: international progress and future directionsLeukemia, 2005
- Successive clinical trials for childhood acute myeloid leukemia at St Jude Children's Research Hospital, from 1980 to 2000Leukemia, 2005
- Treatment strategies and long-term results in paediatric patients treated in four consecutive AML-BFM trialsLeukemia, 2005
- Revised Recommendations of the International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards for Therapeutic Trials in Acute Myeloid LeukemiaJournal of Clinical Oncology, 2004
- Favorable Impact of the t(9;11) in Childhood Acute Myeloid LeukemiaJournal of Clinical Oncology, 2002