Therapy-related acute lymphoblastic leukemia has distinct clinical and cytogenetic features compared to de novo acute lymphoblastic leukemia, but outcomes are comparable in transplanted patients
Ibrahim Aldoss,
Tracey Stiller,
Ni-Chun Tsai,
Joo Y. Song,
Thai Cao,
N. Achini Bandara,
Amandeep Salhotra,
Samer Khaled,
Ahmed Aribi,
Monzr M. Al Malki,
Matthew Mei,
Haris Ali,
Ricardo Spielberger,
Margaret O’Donnell,
David Snyder,
Thomas Slavin,
Ryotaro Nakamura,
Anthony S. Stein,
Stephen J. Forman,
Guido Marcucci,
Vinod Pullarkat
Affiliations
Ibrahim Aldoss
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Tracey Stiller
Department of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA, USA
Ni-Chun Tsai
Department of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA, USA
Joo Y. Song
Department of Pathology, City of Hope, Duarte, CA, USA
Thai Cao
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA;Kaiser Permanente, Department of BMT, Southern California Medical Group, Los Angeles
N. Achini Bandara
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Amandeep Salhotra
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Samer Khaled
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Ahmed Aribi
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Monzr M. Al Malki
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Matthew Mei
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Haris Ali
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Ricardo Spielberger
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA;Kaiser Permanente, Department of BMT, Southern California Medical Group, Los Angeles
Margaret O’Donnell
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
David Snyder
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Thomas Slavin
Department of Medical Oncology, Division of Clinical Genetics, City of Hope, Duarte, CA, USA
Ryotaro Nakamura
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Anthony S. Stein
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Stephen J. Forman
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Guido Marcucci
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Vinod Pullarkat
Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
Therapy-related acute lymphoblastic leukemia remains poorly defined due to a lack of large data sets recognizing the defining characteristics of this entity. We reviewed all consecutive cases of adult acute lymphoblastic leukemia treated at our institution between 2000 and 2017 and identified therapy-related cases - defined as acute lymphoblastic leukemia preceded by prior exposure to cytotoxic chemotherapy and/or radiation. Of 1022 patients with acute lymphoblastic leukemia, 93 (9.1%) were classified as therapy-related. The median latency for therapy-related acute lymphoblastic leukemia onset was 6.8 years from original diagnosis, and this was shorter for patients carrying the MLL gene rearrangement compared to those with other cytogenetics. When compared to de novo acute lymphoblastic leukemia, therapy-related patients were older (P
