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  • Kim, Rathana; Boissel, Nicolas; Touzart, Aurore; Leguay, Thibaut; Thonier, Florian; Thomas, Xavier; Raffoux, Emmanuel; Huguet, Françoise; Villarese, Patrick; Fourrage, Cécile; Passini, Loïc; Hunault, Mathilde; Lepretre, Stéphane; Chevallier, Patrice; Braun, Thorsten; Lhéritier, Véronique; Chantepie, Sylvain; Maury, Sébastien; Escoffre, Martine; Tavernier, Emmanuelle; Chalandon, Yves; Graux, Carlos; Macintyre, Elizabeth; Ifrah, Norbert; Asnafi, Vahid; Dombret, Hervé; Lhermitte, Ludovic

    Leukemia, 07/2020, Letnik: 34, Številka: 7
    Journal Article

    The prognostic value of IL7-receptor pathway (IL7Rp) mutations in T-cell acute lymphoblastic leukemia (T-ALL) remains unclear. We performed a comprehensive study of 200 adult patients with T-ALL included in the GRAALL2003/2005 protocols to address the clinical significance of IL7Rp mutations. Next-generation sequencing of the IL7Rp (IL7R/JAK1/JAK3/STAT5B) revealed that IL7Rp mutations were frequent in adult T-ALL (28%) particularly in immature/early T-cell progenitor (ETP)-ALL. They were associated with mutations of NOTCH-pathway, PHF6, and PRC2 components but not with K/NRAS. IL7Rp mutated (IL7Rp ) T-ALL were slow-responders, with a high rate of M2/M3 day-8 marrow compared with IL7Rp non-mutated (IL7Rp ) T-ALL (p = 0.002) and minimal residual disease positivity at 6-weeks (MRD1) (p = 0.008) but no difference in MRD2 positivity at 12-weeks. Despite this, no adverse prognosis was evidenced when censored for allogeneic hematopoietic stem cell transplantation (HSCT). In time-dependent analysis, HSCT did not benefit IL7Rp patients whereas it was of marked benefit to IL7Rp cases. IL7Rp-mutations identify a subgroup of slow-responder T-ALLs which benefit from post-induction chemotherapy regimens but not from HSCT. Our data suggest that prior knowledge of the mutation status of IL7Rp may influence HSCT decision and help to guide therapy reduction.