Allogeneic hematopoietic stem cell transplantation improves the prognosis of

The prognostic value of inactivation in adult patients with acute lymphoblastic leukemia (ALL) is still under debate, and the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for adult ALL with deletion remains to be evaluated. This study analyzed the clinical implications of deletion in adult ALL and investigated the efficacy of allo-HSCT in patients with deletion. Deletion of was identified in 38.4% of the adult ALL patients, and the prevalences of hemizygous deletion, homozygous deletion and mixed hemi/homozygous of were 22.1, 11.6 and 5.5%, respectively. The prevalence of deletion was 39.7% in B-lineage ALL and 33.3% in T-lineage ALL. Deletion of was significantly associated with higher white blood cell count (p = 0.032) and lower platelets (p = 0.023) but was not related to age, sex, percentage of bone marrow blasts, hepatosplenomegaly, CNS leukemia rate, first complete remission and relapse rate (p > 0.05). Deletion of was significantly correlated with poor outcome in terms of event-free survival (EFS; p = 0.028) and overall survival (OS; p = 0.033). Twenty-two of the 33 patients with deletion received allo-HSCT treatment. Patients with deletion after allo-HSCT experienced higher EFS and OS than those without (52.9 vs 0%, p < 0.001; 46.8 vs 29.1%, p = 0.01, respectively). Multivariate analysis found CNS leukemia and poor response to induction chemotherapy to be the risk factors for EFS and OS, whereas no deletions of and allo-HSCT were favorable factors. Deletion of is a strong adverse prognostic factor in adult ALL. Testing for alterations at diagnosis may help in risk stratification, and we propose to implement testing for deletion in future treatment protocols.