TY - JOUR AU - Sabine Kayser, AU - Robert K. Hills, AU - Marlise R. Luskin, AU - Andrew M. Brunner, AU - Christine Terré, AU - Jörg Westermann, AU - Kamal Menghrajani, AU - Carole Shaw, AU - Maria R. Baer, AU - Michelle A. Elliott, AU - Alexander E. Perl, AU - Zdeněk Ráčil, AU - Jiri Mayer, AU - Pavel Zak, AU - Tomas Szotkowski, AU - Stéphane de Botton, AU - David Grimwade, AU - Karin Mayer, AU - Roland B. Walter, AU - Alwin Krämer, AU - Alan K. Burnett, AU - Anthony D. Ho, AU - Uwe Platzbecker, AU - Christian Thiede, AU - Gerhard Ehninger, AU - Richard M. Stone, AU - Christoph Röllig, AU - Martin S. Tallman, AU - Elihu H. Estey, AU - Carsten Müller-Tidow, AU - Nigel H. Russell, AU - Richard F. Schlenk, AU - Mark J. Levis, PY - 2020/01/01 Y2 - 2024/03/28 TI - Allogeneic hematopoietic cell transplantation improves outcome of adults with t(6;9) acute myeloid leukemia: results from an international collaborative study JF - Haematologica JA - haematol VL - 105 IS - 1 SE - Articles DO - 10.3324/haematol.2018.208678 UR - https://haematologica.org/article/view/9485 SP - 161-169 AB - Acute myeloid leukemia (AML) with t(6;9)(p22;q34) is a distinct entity accounting for 1-2% of AML cases. A substantial proportion of these patients have a concomitant FLT3-ITD. While outcomes are dismal with intensive chemotherapy, limited evidence suggests allogeneic hematopoietic cell transplantation (allo-HCT) may improve survival if performed early during first complete remission. We report on a cohort of 178 patients with t(6;9)(p22;q34) within an international, multicenter collaboration. Median age was 46 years (range: 16-76), AML was de novo in 88%, FLT3-ITD was present in 62%, and additional cytogenetic abnormalities in 21%. Complete remission was achieved in 81% (n=144), including 14 patients who received high-dose cytarabine after initial induction failure. With a median follow up of 5.43 years, estimated overall survival at five years was 38% (95%CI: 31-47%). Allo-HCT was performed in 117 (66%) patients, including 89 in first complete remission. Allo-HCT in first complete remission was associated with higher 5-year relapse-free and overall survival as compared to consolidation chemotherapy: 45% (95%CI: 35-59%) and 53% (95%CI: 42-66%) versus 7% (95%CI: 3-19%) and 23% (95%CI: 13-38%), respectively. For patients undergoing allo-HCT, there was no difference in overall survival rates at five years according to whether it was performed in first [53% (95%CI: 42-66%)], or second [58% (95%CI: 31-100%); n=10] complete remission or with active disease/relapse [54% (95%CI: 34-84%); n=18] (P=0.67). Neither FLT3-ITD nor additional chromosomal abnormalities impacted survival. In conclusion, outcomes of t(6;9)(p22;q34) AML are poor with chemotherapy, and can be substantially improved with allo-HCT. ER -