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Allogeneic haematopoietic stem cell transplantation might overcome the poor prognosis of adolescents and adult patients with T-lineage acute lymphoblastic leukaemia and CDKN2 deletion

Bone Marrow Transplantation (2024)Cite this article

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Abstract

This study delves into the clinical implications of cyclin-dependent kinase inhibitor 2 (CDKN2) deletion in adult T-lineage acute lymphoblastic leukemia (T-ALL). Among 241 patients included in this study, 57 had CDKN2 deletion and 184 had CDKN2 wild-type (WT), and 165 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 76 did not undergo allo-HSCT. CDKN2 deletion correlated with higher white blood cell count, more high-risk diseases, and complex karyotype. The 5-year overall survival (OS) was 36.8% and 58.2% (P < 0.001), 5-year disease-free survival (DFS) was 47.1% and 59.3% (P = 0.018), and 5-year cumulative incidence of relapse (CIR) was 33.7% and 22.3% (P = 0.019) in patients with CDKN2 deletion and WT, respectively. Multivariate analysis identified CDKN2 deletion as an independent adverse prognostic factor for OS (HR 2.11, P = 0.003). In the CDKN2 deletion subgroup, landmark analysis showed that the 5-year OS was 56.7% and 19% (P = 0.002) for patients who underwent allo-HSCT and those who did not, respectively. And multivariate analysis confirmed the beneficial role of allo-HSCT in OS (HR 0.23, P < 0.001). In conclusion, CDKN2 deletion was associated with a poor prognosis in adult T-ALL, and allo-HSCT might be beneficial for this population.

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Fig. 1
Fig. 2: Outcomes for CDKN2 Deletion vs. CDKN2 Wild-type.
Fig. 3: CDKN2 Deletion Subgroup Outcomes with Non-HSCT vs. Allo-HSCT.

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The data that support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

This work was supported by the National Key Research and Development Projects of China (2021YFC2500301-4, 2022YFA1105003, and 2022YFC2502600-5), the Major Project of the National Natural Science Foundation of China (No.82293634), and the National Natural Science Foundation of China (82200241).

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  1. These authors contributed equally: Xiaoshan Hu, Zhixiang Wang, Yuting Qin.

Authors and Affiliations

  1. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Xiaoshan Hu, Zhixiang Wang, Yuting Qin, Jun Xu, Na Xu, Qiang Wang, Ren Lin, Ke Zhao, Hongsheng Zhou, Li Xuan, Sijian Yu & Qifa Liu

  2. Department of Medical Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China

    Xiaoshan Hu

  3. Clinical Medical Research Center of Hematology Diseases of Guangdong Province, Guangzhou, China

    Xiaoshan Hu, Zhixiang Wang, Yuting Qin, Jun Xu, Na Xu, Qiang Wang, Ren Lin, Ke Zhao, Hongsheng Zhou, Li Xuan, Sijian Yu & Qifa Liu

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Contributions

XSH wrote the initial manuscript, ZXW designed tables and figures and YTQ performed the MRD analysis. QFL and SJY designed the initial outline, contributed to the writing, and finalized the manuscript. All authors have read and approved the final manuscript. Xiaoshan Hu: Conceptualization, Methodology, Formal analysis, Writing-original draft. Zhixiang Wang: Methodology and Formal Analysis. Yuting Qin: Formal analysis. Jun Xu, Na Xu, Qiang Wang, Ren Lin, Ke Zhao, Hongsheng Zhou, Li Xuan: Resources, Data Curation. Sijian Yu and Qifa Liu: Conceptualization, writing–review and editing, visualization, supervision, and funding acquisition.

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Hu, X., Wang, Z., Qin, Y. et al. Allogeneic haematopoietic stem cell transplantation might overcome the poor prognosis of adolescents and adult patients with T-lineage acute lymphoblastic leukaemia and CDKN2 deletion. Bone Marrow Transplant (2024). https://doi.org/10.1038/s41409-024-02306-2

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