Intensive pretreatment protocol allogeneic hematopoietic stem cell transplantation to overcome poor prognosis in patients with t(6;9)/DEK-NUP214 acute myeloid leukemia
Objective:To explore the efficacy of an intensified conditioning regimen allogeneic hematopoietic stem cell transplantation(allo-HSCT)for t(6;9)/DEK-NUP214 acute myeloid leukemia(AML).Methods:Between 2015 and 2023,32 AML patients with t(6;9)/DEK-NUP214 fusion gene who underwent allo-HSCT were analyzed.All patients underwent an intensified conditioning regimen.Results:Hematopoietic reconstitution was achieved in all 32 patients,with median days to leukocyte and platelet viability of 13(10-20)and 12(6-29)days,respectively.Pretreatment-related toxicity(RRT)occurred mostly within 2 weeks of pretreatment,with a grade Ⅰ/Ⅱ RRT incidence of 59.3％(19/32),most commonly gastrointestinal reactions(13/32),followed by he-patic injury(9/32).No patients experienced grade Ⅲ/Ⅳ RRT.With a median follow-up of 44(3-107)months af-ter transplantation,the 3-year overall survival(OS)was 90.3％,relapse-free survival(RFS)was 86.2％,cumula-tive relapse rate was 3.1％,and transplant-related mortality was 9.4％.There were 20 patients in complete re-mission at the time of transplantation and 12 patients in no remission,and there was no difference in the compari-son of 3-year OS and RFS between the two groups(OS:95.0％vs 82.5％,P=0.28;RFS:87.7％vs 82.5％,P=0.61).There was no difference in the 3-year OS and RFS in the 20 patients with FLT3-ITD compared with 12 patients without FLT3-ITD(OS:95.0％vs 82.5％,P=0.3;RFS:87.7％vs 82.5％,P=0.63).Conclusion:Intensive pretreatment regimen allo-HSCT overcame poor prognosis and was well tolerated in patients with t(6;9)/DEK-NUP214 AML.Survival was not influenced by the state at transplant and FLT3-ITD.
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维普
