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Blood, 15 June 2007, Vol. 109, No. 12, pp. 5164-5167.
Prepublished online as a Blood First Edition Paper on March 6, 2007; DOI 10.1182/blood-2007-01-069831.
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CLINICAL TRIALS AND OBSERVATIONS
Brief Report
Long-term disease-free survivors with cytogenetically normal acute myeloid leukemia and MLL partial tandem duplication: a Cancer and Leukemia Group B study
Susan P. Whitman1,
Amy S. Ruppert1,2,
Guido Marcucci1,3,
Krzysztof Mrózek1,
Peter Paschka1,
Christian Langer1,3,
Claudia D. Baldus4,
Jing Wen1,
Tamara Vukosavljevic1,
Bayard L. Powell5,
Andrew J. Carroll6,
Jonathan E. Kolitz7,
Richard A. Larson8,
Michael A. Caligiuri1,3, and
Clara D. Bloomfield1
1 Division of Hematology and Oncology, Department of Internal Medicine, Comprehensive Cancer Center, The Ohio State University, Columbus;
2 The Cancer and Leukemia Group B (CALGB) Statistical Center, Duke University Medical Center, Durham, NC;
3 Division of Human Cancer Genetics, Department of Microbiology, Virology, Immunology, and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus;
4 Charité, Campus Benjamin Franklin, Medizinische Klinik III, Berlin, Germany;
5 Section on Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC;
6 University of Alabama at Birmingham;
7 North Shore University Hospital, Manhasset, NY;
8 University of Chicago, IL
The clinical impact of MLL partial tandem duplication (MLL-PTD) was evaluated in 238 adults aged 18 to 59 years with cytogenetically normal (CN) de novo acute myeloid leukemia (AML) who were treated intensively on similar Cancer and Leukemia Group B protocols 9621 and 19808. Twenty-four (10.1%) patients harbored an MLL-PTD. Of those, 92% achieved complete remission (CR) compared with 83% of patients without MLL-PTD (P = .39). Neither overall survival nor disease-free survival significantly differed between the 2 groups (P = .67 and P = .55, respectively). Thirteen MLL-PTD+ patients relapsed within 1.4 years of achieving CR. MLL-PTD+ patients who relapsed more often had other adverse CN-AMLassociated molecular markers. In contrast with previously reported studies, 9 (41%) MLL-PTD+ patients continue in long-term first remission (CR1; range, 2.5-7.7 years). Intensive consolidation therapy that included autologous peripheral stem-cell transplantation during CR1 may have contributed to the better outcome of this historically poor-prognosis group of CN-AML patients with MLL-PTD.

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