Prognosis and treatment outcome in patients with acute myeloid leukemia with t(8;21)(q22;q22).
Patients with acute myeloid leukemia (AML) with the t(8;21) karyotype generally have a favorable clinical course, but key prognostic factors remain poorly defined. This study was conducted to determine the prognoses and treatment outcomes of patients with AML with this unique cytogenetic change. A total of 22 patients with AML with t(8;21)(q22;q22) were studied. Various parameters were tested for their impact on disease-free survival (DFS) and overall survival (OS). Another 55 patients with AML with a normal karyotype were included for comparison of clinical outcomes. Between patients with t(8-21) and those with a normal karyotype, no significant differences were noted in DFS (median survival, 15.23 vs 12.03 mo; P=.7626) and OS (median survival, 19.17 vs 18.93 mo; P=.7543). Among t(8;21)(q22;q22) patients, no clinical parameters showed a significant impact on DFS. Univariate analysis revealed that a higher platelet count (>15.10(9)/L) at diagnosis, a low white blood cell count (index < or =20), and hematopoietic stem cell transplantation (HSCT) as postremission therapy were associated with improved OS. On multivariate analysis, HSCT as postremission therapy and white blood cell count index <20 remained good independent prognostic factors for OS. The data presented here suggest that t(8;21)(q22;q22) cytogenetic changes in patients with AML had prognostic significance similar to that in patients with a normal karyotype; patients who harbored either karyotype had parallel clinical outcomes. It is concluded that patients with AML with t(8;21)(q22;q22) would be compromised by treatment approaches that do not include HSCT as postremission therapy.
Chen
Chih-Cheng
CC
Department of Medicine, Division of Hematology/Oncology, Chang Gung Memorial Hospital-Chiayi, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
Gau
Jyh-Pyng
JP
Yu
Yaun-Bin
YB
Lu
Chang-Hsien
CH
Lee
Kuan-Der
KD
You
Jie-Yu
JY
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002891:Chromosomes, Human, Pair 21; D002898:Chromosomes, Human, Pair 8; D018572:Disease-Free Survival; D005260:Female; D006403:Hematologic Tests; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014178:Translocation, Genetic; D016896:Treatment Outcome