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Therapy-related ALL: cytogenetic features and hematopoietic cell transplantation outcome

Bone Marrow Transplantation volume 50, pages 746–748 (2015)Cite this article

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Therapy-related leukemia has been described after chemotherapy, radiation and autologous hematopoietic SCT. The majority of such cases are therapy-related AML/myelodysplastic syndrome (t-AML/MDS) and the cytogenetic and molecular features of these cases are well defined.1 On the other hand, therapy-related ALL (t-ALL) has been described infrequently in the literature. The clinical and pathological characteristics as well as treatment outcomes of t-ALL remain poorly defined. Although mixed myeloid leukemia (MLL) gene rearrangement is the most recurrent cytogenetic abnormality associated with t-ALL in the literature, other chromosomal alterations have been described.2, 3, 4, 5, 6, 7

Herein, we examined the pathologic features and treatment outcomes of a cohort of t-ALL patients who underwent allogeneic hematopoietic cell transplantation (HCT) at our institution in order to better characterize the cytogenetic profile of t-ALL, and to examine outcomes of t-ALL post allogeneic HCT. We reviewed a consecutive case series of adult ALL patients who underwent allogeneic HCT at City of Hope between 1998 and 2014. We excluded patients with prior malignancies who did not receive chemotherapy or/and radiation before ALL onset. Continuous variables were tested between the leukemia cytogenetic abnormality subgroups, namely MLL gene rearrangement-positive and Ph-positive, and others (all cases excluding those with MLL gene rearrangement and Ph chromosome) using the Wilcoxon rank-sum test. Categorical variables were tested using Fisher’s exact test. Survival estimates were calculated from the date of transplantation, and tested using the log-rank test of Mantel and Haenszel for OS and leukemia-free survival (LFS). Cumulative incidence of relapse (CIR) with non-relapse-related mortality (NRM) as a competing risk was plotted and tested using prevalence methods developed by Gray.

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Authors and Affiliations

  1. Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA, USA

    I Aldoss, S Forman & V Pullarkat

  2. Division of Biostatistics, Department of Information Sciences, City of Hope Medical Center, Duarte, CA, USA

    A Dagis & J Palmer

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  1. I Aldoss
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  2. A Dagis
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  3. J Palmer
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Correspondence to I Aldoss.

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Aldoss, I., Dagis, A., Palmer, J. et al. Therapy-related ALL: cytogenetic features and hematopoietic cell transplantation outcome. Bone Marrow Transplant 50, 746–748 (2015). https://doi.org/10.1038/bmt.2015.8

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