Search

Sixty-two infants with MLL gene-rearrangement-positive acute lymphoblastic leukemia (MLL-r ALL) were treated with the MLL03 protocol of the Japanese Pediatric Leukemia/Lymphoma Study Group: short-course intensive chemotherapy followed by early allogeneic hematopoietic stem cell transplantation (HSCT) within 4 months of the initial induction. The 4-year event-free survival and overall survival rates were 43.2% (95% confidence interval (CI)=30.7-55.1%) and 67.2% (53.8-77.4%), respectively. A univariate analysis showed younger age (<90 days at diagnosis), central nervous system disease and poor response to initial prednisolone therapy significantly associated with poor prognosis (P<0.05). In a multivariate analysis, younger age at diagnosis tended to be associated with poor outcome (hazard ratio=1.969; 95% CI=0.903-4.291; P=0.088). Although the strategy of early use of HSCT effectively prevented early relapse and was feasible for infants with MLL-r ALL, the fact that substantial number of patients still relapsed even though transplanted in their first remission indicates the limited efficacy of allogeneic HSCT for infants with MLL-r ALL. Considering the risk of severe late effects, indications for HSCT should be restricted to specific subgroups with poor risk factors. An alternative approach incorporating molecular-targeted drugs should be established. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the pathogenesis and high frequencies of novel splicing-factor mutations juvenile myelomonocytic leukemia (JMML).

A letter to the editor is presented which discusses the discovery of the mutation of casitas B-lineage lymphoma (CBL) in childhood therapy-related leukemia.

A letter to the editor is presented regarding the study on the incidence and prognosis of isocitrate dehydrogenase gene (IDH1) and IDH2 mutations in pediatric myeloid malignancies.

A letter to the editor is presented regarding the mutations of isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) in a series of cases with myelodysplastic syndrome (MDS).

Presents a letter the editor in response to the article "Mutations of the Notch1 Gene in T-Cell Acute Lymphoblastic Leukemia: Analysis in Adults and Children," previously published in the journal "Leukemia."

Analyzes mutations in the runt domain of acute myeloid leukemia 1 by polymerase chain reaction or reverse transcriptase-polymerase chain reaction-single-strand conformation polymorphism in pediatric Down syndrome patients with hematological malignancies. Heterozygous missense mutation; Role of mutation in development of hematological disorders.