HLA-Matched and HLA-Haploidentical Hematopoietic Stem Cell Transplantation for Acute Myelogenous Leukemia with t (16;21) (p11.2;q22)

抄録

 Acute myelogenous leukemia (AML) with t (16;21) (p11;q22) is a rare leukemia subtype with a relatively high incidence in young individuals and a poor prognosis. This chromosomal rearrangement results in FUS-ERG fusion transcripts. We describe a patient with AML with t (16;21) (p11;q22) who underwent successful monitoring for FUS-ERG fusion transcripts by real-time quantitative polymerase chain reaction (RT-qPCR). We designed DNA primers based on the leukemic cells of this patient and monitored minimal residual disease by RT-qPCR. Standard multiagent chemotherapy for AML could not reduce FUS-ERG expression level to 10³, whereas hematopoietic stem cell transplantation (HSCT) knocked down the expression level to 10 or lower. The patient underwent HSCT twice, and FUS-ERG expression decreased rapidly, especially after human leukocyte antigen (HLA)-haploidentical HSCT. Although the patient suffered multiple early recurrences after HSCTs, this case suggests that HLA-haploidentical HSCT is one of the options for AML with t (16;21) (p11;q22), even though the benefits are limited. Further research is needed to optimize the course of treatment including pre-transplant treatment, HSCT, and post-transplant treatment strategies (Trial registration: jRCTs051180119).