Adult de novo acute myeloid leukemia with t(6;11)(q27;q23)

Abstract

BACKGROUND Acute myeloid leukemia (AML) with t(6;11)(q27;q23) is a well established but rare entity, and few studies have reported the full clinical, hematologic, and outcome data of patients with this disease. METHODS To characterize the features of t(6;11) AML, the authors searched the Cancer and Leukemia Group B (CALGB) cytogenetic database comprising 2667 adults with newly diagnosed, de novo AML and identified 16 patients (0.6%) with t(6;11). A review of the literature identified 33 adults with de novo t(6;11) AML for whom survival data were available. RESULTS CALGB patients had a median age of 45 years (range, 22–65 years) and commonly presented with French–American–British (FAB) subtype M4 or M5 (81%). Gingival involvement at presentation was common (31%). All patients with gingival involvement had FAB M4. Compared with other patients with M4 AML in the CALGB database (n = 429), patients with M4 and t(6;11) (n = 7) had a higher frequency of gingival hypertrophy at presentation (71% vs. 17%, P = 0.003). Patients with t(6;11) were more likely to be African American (P = 0.02) and to die during induction (P = 0.03) than those without t(6;11). The complete response (CR) rate was 69% (11 of 16 patients), and CR duration was short (median, 9 months). The estimated probability of 2‐year survival was 13%. Both long‐term survivors received allogeneic stem cell transplantation. The estimated probability of 2‐year survival of patients reported in the literature was 15%. CONCLUSIONS Although the patient sample was small, the authors suggested that investigational approaches, including allogeneic transplantation, be considered for adults with t(6;11) AML. Cancer 2004. © 2004 American Cancer Society.

Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials

“…Interestingly, both of these abnormalities have been associated with a poor prognosis in previous studies, [43][44][45][46][47] including a recent large international pediatric study considering 756 cases of AML with MLL translocations. 47 In the latter study, the most favorable outcome was observed in cases with t(1;11)(q21;q23), although this abnormality was too infrequent in our series (n ϭ 3) to consider its prognostic significance in adults.…”

Novel prognostic subgroups in childhood 11q23/MLL-rearranged acute myeloid leukemia: results of an international retrospective study

“…In adult AML, the poor outcome of patients with a t(6;11)(q27;q23) has been reported before, and adults with this specific translocation do equally bad (2-year OS, 13%). 29 Of interest, children with a t(6;11)(q27;q23) have a higher WBC and older age at presentation than other MLL-rearranged cases. We could not prove that allogeneic HSCT was of benefit in these patients, but numbers were limited.…”

Prognostic significance of 11q23 aberrations in adult acute myeloid leukemia and the role of allogeneic stem cell transplantation

“…However, t(6;11) was shown to be an independent poor prognostic feature in adult AML (Tables 2). Adverse outcomes of patients with t(6;11) have been reported in pediatric AML 12 and adult AML by Cancer and Leukemia Group B 15 and the German AML Intergroup. 16 Given the dismal outcomes of these patients, clinical trials using novel strategies should be encouraged for this group.…”

“…Furthermore, information on the potential therapeutic role of allogeneic stem cell transplantation (allo-SCT) in this subgroup is scarce, as most of the published studies involved groups that were too small to allow definitive conclusions. 15, 16 …”