Journal
BONE MARROW TRANSPLANTATION
Volume 54, Issue 2, Pages 236-243Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/s41409-018-0249-7
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Funding
- National Key R&D Program of China [2016YFC0902800]
- National Natural Science Foundation of China [81270645]
- Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD)
- Frontier Clinical Technical Project of the Science and Technology Department of Jiangsu Province [BE2017655]
- Jiangsu Provincial Medical Talent [ZDRCA2016045]
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To investigate the prognosis of patients with adult B-cell acute lymphoblastic leukemia (B-ALL) with Ikaros family zincfinger 1 (IKZF1) mutation and determine the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in improving the clinical outcome, we detected the IKZF1 mutation and BCR-ABL fusion gene at diagnosis in the bone marrow of 164 adult patients with B-ALL, and analyzed the clinical data of these patients retrospectively. Our analysis showed that grade III-IV acute graft-versus-host disease and IKZF1 mutation in the transplantation group and age and IKZF1 mutation in the non-transplantation group were independent factors for poor prognosis by univariate and multivariate analyses. The 3-year overall survival (OS) and leukemia-free survival (LFS) rates were much lower in the IKZF1+/BCR-ABL+ subgroup than in the IKZF1+/BCR-ABL- and IKZF1-/BCR-ABL- subgroups in both the transplantation and non-transplantation groups. The 3-year OS and LFS rates were significantly higher in the transplantation group than in the non-transplantation group with IKZF1 mutation. The study demonstrated that IKZF1 mutation was an independent factor indicating the poor prognosis of adult B-ALL and much worse prognosis in the BCR-ABL+ subgroup in both non-transplantation and transplantation groups. However, allo-HSCT significantly improved the OS and LFS of patients and also their clinical outcomes.
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