[Clinical analysis of newly diagnosed acute lymphoblastic leukemia with 11q23/MLL gene rearrangement]

To analyze the laboratory and clinical features and prognosis of patients with acute lymphoblastic leukemia (ALL) and 11q23/MLL gene rearrangement.

A total of 725 patients with ALL were enrolled. The 11q23/MLL gene rearrangement and its partner genes were detected. The clinical and laboratory features and prognosis of patients with MLL gene rearrangement were analyzed.

MLL gene rearrangement was detected in 42 cases (5.8%) of the patients, with the dominant immunophenotype being pro-B-ALL. Among the partner genes, the MLL/AF4 was the most common. Compared with the non-MLL/AF4 group, the MLL/AF4 group had higher white blood cell and immature cell counts. No significant difference was found in complete remission and 1-year overall survival (OS) rates between the two groups (P> 0.05). Compared with the non-MLL/AF4 group, the MLL/AF4 group had a higher recurrence rate (P<0.05) and a lower 3-year OS rate (P<0.05). Compared with the untransplantation group, the transplantation group had higher 2-year OS and progress free survival rates (P<0.05). Multivariate analysis suggested age ≤1 year, MLL/AF4 positive, early recurrence, and allogeneic hematopoietic stem cell transplant (Allo-HSCT) to be independent factors which can influence the survival of ALL patients with 11q23/MLL rearrangement (P<0.05).

MLL/AF4 is the most common partner gene for 11q23/MLL gene rearrangement. This type of leukemia is mainly pro-B-ALL. Although conventional chemotherapy can achieve certain rate of remission, it is easy to relapse and the prognosis is very poor. Allo-HSCT may improve the prognosis.