Abstract
BACKGROUND AND OBJECTIVES: Acute myeloid leukaemia (AML) with the translocation of chromosome (6;9)(p23;q34) forms the DEK-NUP214 fusion mRNA, which is a rare subtype (~1%). Owing to the paucity of this AML subtype, comprehensive studies analysing allogeneic haematopoietic stem cell transplantation (allo-HSCT) outcomes are lacking. METHODS: We aimed to evaluate the dynamic evolution of DEK-NUP214 transcripts before and after allo-HSCT as well as the impact of pretransplant DEK-NUP214 status on posttransplant outcomes in AML patients in a retrospective, multicentre study (n = 14). RESULTS: Intermediate- or high-risk AML patients without DEK-NUP214 transcripts receiving allo-HSCT during the same time period were enrolled as controls. Ten (71.4%) patients showed DEK-NUP214 positivity before allo-HSCT. Except for one patient who died early after allo-HSCT, 7 out of the other 9 patients (77.8%) achieved DEK-NUP214 negativity after allo-HSCT. The 2-year probabilities of relapse, non-relapse mortality (NRM), leukaemia-free survival (LFS), and overall survival (OS) were 14.3% (95% CI, 0%-33.6%), 35.7% (95% CI, 9.3%-62.1%), 50.0% (95% CI, 29.6%-84.4%), and 50.0% (95% CI, 29.6%-84.4%), respectively. The incidence of relapse was comparable between AML patients with and without DEK-NUP214 transcript, but the incidence of NRM, LFS, and OS of patients with DEK-NUP214 was poorer compared with those without DEK-NUP214 transcript. CONCLUSIONS: Thus, this study observed that allo-HSCT could overcome the poor prognosis of persistent DEK-NUP214 positivity after chemotherapy; however, new therapies should be further identified to improve the outcomes of AML patients with DEK-NUP214.