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Allogeneic stem cell transplantation improves the outcome of adults with t(1;19)/E2A-PBX1 and t(4;11)/MLL-AF4 positive B-cell acute lymphoblastic leukemia: results of the prospective multicenter LALA-94 study.
Vey N., Thomas X., Picard C., Kovascovicz T., Charin C. et al
Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 20, 12 (2006) 2155-61 - http://hal.archives-ouvertes.fr/hal-00453293
Sciences du Vivant/Immunologie
Allogeneic stem cell transplantation improves the outcome of adults with t(1;19)/E2A-PBX1 and t(4;11)/MLL-AF4 positive B-cell acute lymphoblastic leukemia: results of the prospective multicenter LALA-94 study.
N. Vey, X. Thomas1, C. Picard2, T. Kovascovicz, C. Charin, J. M. Cayuela, H. Dombret, N. Dastugue, F. Huguet3, C. Bastard, A. Stamatoulas, M. Giollant, O. Tournilhac, E. Macintyre, A. Buzyn, D. Bories, M. Kuentz4, F. Dreyfus4, A. Delannoy5, S. Raynaud6, N. Gratecos4, Dominique Bordessoule ()7, 8, 9, 10, S. De Botton, C. Preudhomme11, O. Reman, X. Troussard, A. Pigneux, C. Bilhou, J. P. Vernant, C. Boucheix12, J. Gabert13,
1 :  Laboratoire de Chimie et Biochimie des Substances Naturelles
CNRS : UMR5154
Département RDDM Case Postale 54 57 rue Cuvier F 75005 PARIS
France
2 :  Danone Research
http://www.danone.com/
Groupe DANONE
France
3 :  Recherche & Développement
EDF
France
4 :  Service greffe de moelle osseuse
Assistance publique - Hôpitaux de Paris (AP-HP) – Hôpital Saint-Louis – Université Paris VII - Paris Diderot
Paris
France
5 :  GANIL - Grand Accélérateur National d'Ions Lourds
http://www.ganil-spiral2.eu
CNRS : UPR3266 – IN2P3 – CEA : DSM/GANIL
Bvd Henri Becquerel - BP 55027 - 14076 CAEN CEDEX 5
France
6 :  Laboratoire d'oncohématologie
Hôpital Pasteur Nice – CHU Nice
Nice
France
7 :  Laboratoire d'hématologie
CHU Limoges
2 avenue Martin Luther King 87042 Limoges Cedex
France
8 :  Service d'Hématologie Clinique et thérapie cellulaire
CHU Limoges
2 avenue Martin Luther King 87042 Limoges cedex
France
9 :  Faculté de Médecine
http://www.medecine.unilim.fr/
Université de Limoges
2 rue du Dr Marcland 87025 Limoges Cedex
France
10 :  PMRIL - Physiologie moléculaire de la réponse immune et des lymphoproliférations
CNRS : UMR6101 – Université de Limoges – IFR145 GEIST
2 Rue du docteur Marcland 87025 LIMOGES CEDEX
France
11 :  Laboratoire d'Hématologie
CHRU Lille
Lille France
France
12 :  Différenciation hématopoïétique normale et leucémique
INSERM : U268
Hôpital Paul brousse 14-16 av Paul Vaillant Couturier 94807 Villejuif Cedex
France
13 :  IBCP - Institut de biologie et chimie des protéines [Lyon]
http://www.ibcp.fr
CNRS : UMR5086 – Université Claude Bernard - Lyon I (UCBL)
7 Passage du Vercors 69367 LYON CEDEX 07
France
Adult patients with acute lymphoblastic leukemia (ALL) and t(1;19)/E2A-PBX1 or t(4;11)/MLL-AF4 have a poor outcome. We have evaluated the impact of an intensified post-remission therapy using a high-dose chemotherapy course followed by allogeneic or autologous SCT on the outcome of 58 patients with t(1;19)/E2A-PBX1 (E2A group, n=24) or t(4;11)/MLL-AF4 (MLL group, n=34) treated in the LALA-94 multicenter prospective study. Patients in the MLL group had higher WBC counts and more frequent DIC. CR rates achieved by MLL and E2A groups were similar to other B-cell ALL (87, 82 and 86% respectively). While in CR, patients with a donor were assigned to alloSCT (n=22), the remaining patients with were randomized between autoSCT (n=15) or chemotherapy (n=8). Five-year overall survival was 31 and 45% for E2A and MLL groups, respectively. In both groups, DFS was higher in the alloSCT arm as compared to autoSCT and chemotherapy arms. The results of this study show that chemotherapy intensification did not overcome the poor prognosis of adults with t(1;19)/E2A-PBX1. Allogeneic SCT should thus be offered in first CR to patients with t(1;19)/E2A-PBX1 or t(4;11)/MLL-AF4. New therapeutic approaches are needed for patients without donor.
Anglais

Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K.
internationale
Articles dans des revues avec comité de lecture
12/2006
12/10/2006
20
12
2155-61

Adolescent – Adult – Basic Helix-Loop-Helix Transcription Factors – Burkitt Lymphoma – Chromosomes – Human – Pair 1 – Pair 11 – Pair 19 – Pair 4 – DNA-Binding Proteins – Female – Hematopoietic Stem Cell Transplantation – Humans – Male – Middle Aged – Myeloid-Lymphoid Leukemia Protein – Nuclear Proteins – Prospective Studies – Proto-Oncogene Proteins – Translocation – Genetic – Transplantation – Homologous