The following article features coverage from the 2021 American Society of Hematology Annual Meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Oligoblastic myeloid neoplasms with KMT2A rearrangements should be classified as acute myeloid leukemia (AML), regardless of blast count, according to research presented at the 2021 American Society of Hematology (ASH) Annual Meeting.

Patients with KMT2A rearrangements and less than 20% blasts are currently classified as myelodysplastic syndromes (MDS) or chronic myelomonocytic leukemia (CMML) and may be inadequately treated, said Sergej Konoplev, MD, PhD, of The University of Texas MD Anderson Cancer Center in Houston, who presented this research at the meeting.

For this study, Dr Konoplev and colleagues compared clinical characteristics and outcomes of patients who had untreated AML with KMT2A rearrangements and patients with oligoblastic myeloid neoplasms and KMT2A rearrangements.


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The researchers compared 88 patients with AML to 22 patients with MDS (n=5) or CMML (n=17). The median age was 61 years (range, 27-72 years) in the MDS/CMML cohort and 52 years (range, 18-87 years) in the AML cohort.

The percentage of bone marrow blasts was 5% in the MDS/CMML cohort and 73% in the AML cohort (P <.0001). The percentage of blasts in the peripheral blood was 0% and 35%, respectively (P <.0001).

Most patients with MDS/CMML progressed to AML (17/22), and the median time to AML progression was 4 months.

There was no difference in overall survival (OS) between patients who had MDS/CMML at baseline and those with AML at baseline (P =.906).

In a multivariable analysis, neither disease classification (AML vs MDS/CMML) nor blast percentage were associated with OS.

OS was associated with therapy-related disease (hazard ratio [HR], 1.774; 95% CI, 1.058-2.975; P =.03), stem cell transplant (HR, 0.166; 95% CI, 0.000-0.291; P <.0001), and platelet count (HR, 0.992; 95% CI, 0.000-0.998; P =.013).

“Our findings suggest that all myeloid neoplasms with KMT2A rearrangement should be classified as acute myeloid leukemia, irrespective of the blast count,” Dr Konoplev concluded.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.

Reference

Konoplev S, Tang G, Wang X, et al. Oligoblastic (<20%) myeloid neoplasms with KMT2A (MLL) rearrangement show significant overlap with acute myeloid leukemia (AML) and should be regarded as AML. Presented at ASH 2021; December 11-14, 2021. Abstract 793.