Originally published as JCO Early Release 10.1200/JCO.2008.16.7981 on April 20 2009

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Prognostic Factors in Adult Patients up to 60 Years Old With Acute Myeloid Leukemia and Translocations of Chromosome Band 11q23: Individual Patient Data–Based Meta-Analysis of the German Acute Myeloid Leukemia Intergroup

From the Departments of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation and Cellular and Molecular Pathology, Hannover Medical School, Hannover; Institute of Pharmaceutical Biology/Diagnostic Center of Acute Leukemia/Zentrum für Arzneimittelforschung, Entwicklung, und Sicherheit, Johann Wolfgang Goethe University, Biocenter, Frankfurt am Main; Medizinische Klinik und Poliklinik I, Universitätsklinikum C.G. Carus, Dresden; Department of Hematology and Oncology, University of Leipzig, Leipzig; Universitätsklinikum Münster, Medizinische Klinik und Poliklinik A; Department of Medical Informatics and Biomathematics, University of Münster, Münster; and Department Internal Medicine III, University of Ulm, Ulm, Germany.

Corresponding author: Jürgen Krauter, MD, Department Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str 1, D-30625 Hannover, Germany; e-mail: Krauter.Juergen{at}MH-Hannover.de.

Purpose To identify risk factors for induction success and overall survival (OS) and relapse-free survival (RFS) and to evaluate the impact of allogeneic stem-cell transplantation (alloSCT) in adult patients up to 60 years old with acute myeloid leukemia (AML) and reciprocal translocations involving chromosome band 11q23 [t(11q23)].

Patients and Methods An individual patient data-based meta-analysis was performed on 180 adult patients with AML and t(11q23). These patients were identified by cytogenetics and/or molecular techniques and treated within eight prospective multicenter trials of the German AML Intergroup. The median follow-up time was 53 months.

Results Complete remission rate was 71%. Favorable factors for induction success were the presence of a t(9;11), t(11q23) as a sole aberration, and de novo leukemia. OS rate at 4 years was 29%. Translocations other than t(9;11), platelets less than the median, secondary leukemia, and peripheral blasts greater than the median were adverse risk factors for OS. RFS rate at 4 years was 29%. The presence of a t(6;11) and peripheral blasts greater than the median had a negative impact on RFS. Three risk groups for OS and RFS could be defined by the combination of these factors with 4-year OS rates of 50%, 28%, and 5% and 4-year RFS rates of 37%, 26%, and 5%. An alloSCT from matched related or unrelated donors in first complete remission was beneficial, especially in t(6;11)-negative patients.

Conclusion Risk stratification of AML patients with reciprocal translocations of chromosome band 11q23 is feasible based on the translocation partner and clinical parameters.

Supported in part by Grant No. 01GI0378 from the Bundesministerium für Bildung und Forschung (Kompetenz-netz "Akute und Chronische Leukämien"), Germany.

Presented in part at the 48th Annual Meeting of the American Society of Hematology, December 9-12, 2006, Orlando, FL; and at the 49th Annual Meeting of the American Society of Hematology, December 8-11, 2007, Atlanta, GA.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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