title: Prognosis of inv(16)/t(16;16) acute myeloid leukemia (AML): a survey of 110 cases from the French AML Intergroup.
abstract: Acute myeloid leukemias (AMLs) carrying inv(16)/t(16;16) chromosomal abnormalities are associated with a good prognosis. However, studies of this AML subtype have been hampered by the few number of patients reported, frequently collectively considered with those with AML carrying the t(8;21) translocation. We performed a retrospective study in 110 patients with inv(16)/t(16;16) AML (median age, 34 years) prospectively enrolled in 6 trials conducted in France between 1987 and 1998, with the aim to investigate prognostic factors for complete remission (CR) achievement and outcome of CR patients in this AML subtype. CR rate was 93%. Bad-prognosis factors for CR achievement were higher white blood cell count (WBC) and lower platelet count (optimal cutpoints at 120 and 30 x 109/L, respectively). At 3 years, estimated overall survival, disease-free survival (DFS), and cumulative incidence of relapse were 58%, 48%, and 42%, respectively. In multivariate analysis, (1) advanced age (optimal cutpoint, 35 years) was the only factor for shorter DFS and (2) advanced age and low platelet count were the 2 factors for shorter survival of CR patients. Outcome of CR patients (1) was not influenced by WBC and cytogenetic findings and (2) was similar among patients allocated to receive allogeneic transplantation, high-dose, or intermediate-dose cytarabine. Interestingly, advanced age was associated with a trend for more frequent additional chromosome abnormalities and predictive of higher cumulative incidence of relapse rather than death in first CR. These results markedly contrast with those reported in patients with t(8;21) AML in whom WBC, and not age, was the main high-risk factor for relapse, DFS, and survival.
authors.affiliation: Departement of Hematology, Hôpital Saint-Louis, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Thierry
authors.initials: T
authors.lastname: Leblanc
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Françoise
authors.initials: F
authors.lastname: Rigal-Huguet
authors.forename: Francis
authors.initials: F
authors.lastname: Witz
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamy
authors.forename: Anne
authors.initials: A
authors.lastname: Auvrignon
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pigneux
authors.forename: Francine
authors.initials: F
authors.lastname: Mugneret
authors.forename: Christian
authors.initials: C
authors.lastname: Bastard
authors.forename: Nicole
authors.initials: N
authors.lastname: Dastugue
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Van den Akker
authors.forename: Denis
authors.initials: D
authors.lastname: Fière
authors.forename: Josy
authors.initials: J
authors.lastname: Reiffers
authors.forename: Sylvie
authors.initials: S
authors.lastname: Castaigne
authors.forename: Guy
authors.initials: G
authors.lastname: Leverger
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Herve
authors.initials: H
authors.lastname: Dombret
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D007446:Chromosome Inversion; D002885:Chromosomes, Human, Pair 16 / Q000648:ultrastructure*; D002986:Clinical Trials as Topic; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality; D015479:Leukemia, Myelomonocytic, Acute / Q000235:genetics / Q000401:mortality*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D008942:Mitoxantrone; C002205:zorubicin; D015255:Idarubicin; D003630:Daunorubicin