Is stem cell transplant effective in t(16;21) acute myeloid leukemia patients?

This study aimed to investigate the effectiveness of allogeneic hematopoietic stem cell transplant in patients with t(16;21) acute myeloid leukemia.

This study concluded that allogenic hematopoietic stem cell transplant may be a suitable treatment for these patients.  

Some patients with acute myeloid (AML) have particular genetic abnormalities associated with their cancer. One abnormality is t(16;21) AML. This is a rare type of AML. These patients have poor outcomes with chemotherapy.

An allogeneic hematopoietic stem cell transplant (alloHSCT) is the standard treatment option for AML. It involves taking stem cells from a donor and transferring them to the AML patient. Stem cells can produce any cell type and help to restore the immune system. 

Minimal residual disease (MRD) presents as a small number of cancer cells that remain after treatment and can lead to relapse (cancer returning). It was not known how effective monitoring MRD and treatment with alloHSCT would be for t(16;21) AML patients.

This study involved 14 patients with t(16;21) AML who underwent alloHSCT. Translocation liposarcoma-ETS-related gene (TLS-ERG) transcript levels were measured for an average of 15 months after alloHSCT. These levels reflect MRD.

The 2-year incidence rate of relapse after alloHSCT was 66.2%. The 2-year disease free survival after alloHSCT (time from treatment until return of AML) was 30.8%. The 2-year overall survival (time from treatment until death from any cause) after alloHSCT was 46.2%.

33.3% of patients who had undetectable TLS-ERG levels before alloHSCT relapsed. Four patients who had continually low TLS-ERG levels after alloHSCT remained alive and in complete remission (no sign of active disease). In the 8 patients that relapsed, the TLS-ERG levels increased before the relapse.

Seven patients had TLS-ERG levels of greater than 5% before alloHSCT. When they received alloHSCT they experienced an increase or brief decrease, followed by an increase. Six of these patients relapsed. One patient had a TLS-ERG level of less than 1%. After alloHSCT it decreased to undetectable levels. 

This study concluded that alloHSCT is a suitable option for patients with t(16;21) AML. It also concluded that TLS-ERG levels reflect MRD and may predict relapse. 

Larger studies need to be carried out. 

Consult your physician about alloHSCT as a treatment option for t (16;21) AML.