The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations.
To better understand the spectrum of adult acute myeloid leukaemia (AML) associated with core binding factor (CBF) translocations, 370 patients with newly diagnosed CBF-associated AML were analysed. Patients' age ranged from 16-83 years (median 39 years) with a slight male predominance (55%); 53% had inv(16); 47% had t(8;21). Patients with t(8;21) tended to be younger (P = 0.056), have lower peripheral blood white cell counts (P < 0.0001) and were more likely to have additional cytogenetic abnormalities (P < 0.0001). Loss of sex chromosome, del(9q) and complex abnormalities were more common among patients with t(8;21), while +22 and +21 were more common with inv(16). Overall, 87% [95% confidence interval (CI) 83-90%] of patients achieved complete response (CR) with no difference between t(8;21) and inv(16); however, the CR rate was lower in older patients due to increased resistant disease and early deaths. Ten-year overall survival (OS) was 44% (95% CI 39-50%) and, in multivariate analysis, was shorter with increasing age (P < 0.0001), increased peripheral blast percentage (P = 0.0006), in patients with complex cytogenetic abnormalities in addition to the CBF translocation (P = 0.021), and in patients with t(8;21) (P = 0.025). OS was superior in patients who received regimens with high-dose cytarabine, a combination of fludarabine and intermediate-dose cytarabine, or haematopoietic cell transplantation.
Appelbaum
Frederick R
FR
Southwest Oncology Group Statistical Center, Seattle, WA, USA. fappelb@fhcrc.org
Kopecky
Kenneth J
KJ
Tallman
Martin S
MS
Slovak
Marilyn L
ML
Gundacker
Holly M
HM
Kim
Haesook T
HT
Dewald
Gordon W
GW
Kantarjian
Hagop M
HM
Pierce
Sherry R
SR
Estey
Elihu H
EH
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D050660:Core Binding Factors / Q000235:genetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007951:Leukemia, Myeloid / Q000097:blood / Q000188:drug therapy / Q000235:genetics*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014178:Translocation, Genetic; D016896:Treatment Outcome
D050660:Core Binding Factors