The impacts of BCR-ABL1 mutations in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent allogeneic hematopoietic cell transplantation.
Ann Hematol
; 99(10): 2393-2404, 2020 Oct.
Article
en En
| MEDLINE
| ID: mdl-32803312
ABSTRACT
The prognostic impacts of BCR-ABL1 fusion gene mutations in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) remain unknown. Using data from a nationwide Japanese registry, we have evaluated the prognostic impact of BCR-ABL1 mutations prior to the first allogeneic hematopoietic cell transplantation (HCT). The cohort included 289 patients with a median of 48 years of age (range 16-70). Point mutations were detected in 110 patients. Of these, 90 (82%) harbored T315I mutations, while 20 had other mutations. With a median follow-up period of 29 months (range 1-125), outcomes after 2 years were worse with mutations than without (overall survival [OS] 34% vs 68%, p < 0.001; relapse rate [RR] 48% vs 18%, p < 0.001), particularly with the presence of the T315I mutation (OS 29% vs 68%, p < 0.001; RR 54% vs 18%, p < 0.001). OS was significantly worse in the T315I group even among the cohort with hematological (p < 0.001) or molecular complete remission (p = 0.025) as compared to the no mutation group. Multivariate analysis determined the prognostic impact of the T315I mutation (OS hazard ratio [HR] = 2.19, 95% confidence interval [CI] 1.5-3.3, p < 0.001; RR HR = 2.51, 95% CI 1.5-4.2, p < 0.001). This study is the first to report on the prognostic significance of BCR-ABL1 mutations in Ph + ALL.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cromosoma Filadelfia
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Proteínas de Fusión bcr-abl
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Mutación Puntual
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Trasplante de Células Madre Hematopoyéticas
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Mutación Missense
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Leucemia-Linfoma Linfoblástico de Células Precursoras
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Ann Hematol
Asunto de la revista:
HEMATOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón