Hematopoietic stem cell transplantation for core binding factor acute myeloid leukemia: t(8;21) and inv(16) represent different clinical outcomes.
We analyzed 338 adult patients with acute myeloid leukemia (AML) with t(8;21) and inv(16) undergoing stem cell transplantation (SCT) who were registered in the Japan Society for Hematopoietic Cell Transplantation database. At 3 years, overall survival (OS) of patients with t(8;21) and inv(16) was 50% and 72%, respectively (P= .002). Although no difference was observed when restricted to allogeneic SCT in first complete remission (CR; 84% and 74%), OS of patients with t(8;21) and inv(16) undergoing allogeneic SCT in second or third CR (45% and 86% at 3 years; P= .008) was different. OS was not different between patients in first CR who received allogeneic SCT and those who received autologous SCT for both t(8;21) AML (84% vs 77%; P= .49) and inv(16) AML (74% vs 59%; P= .86). Patients with inv(16) not in CR did better after allogeneic SCT than those with t(8;21) (70% and 18%; P= .03). Patients with t(8;21) and inv(16) should be managed differently as to the application of SCT. SCT in first CR is not necessarily recommended for inv(16). For t(8;21) patients in first CR, a prospective trial is needed to clarify the significance of autologous SCT and allogeneic SCT over chemotherapy.
Kuwatsuka
Yachiyo
Y
Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan. kuwatsuka-ngy@umin.ac.jp
Miyamura
Koichi
K
Suzuki
Ritsuro
R
Kasai
Masaharu
M
Maruta
Atsuo
A
Ogawa
Hiroyasu
H
Tanosaki
Ryuji
R
Takahashi
Satoshi
S
Koda
Kyuhei
K
Yago
Kazuhiro
K
Atsuta
Yoshiko
Y
Yoshida
Takashi
T
Sakamaki
Hisashi
H
Kodera
Yoshihisa
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D007446:Chromosome Inversion; D002885:Chromosomes, Human, Pair 16; D002891:Chromosomes, Human, Pair 21; D002898:Chromosomes, Human, Pair 8; D050660:Core Binding Factors / Q000235:genetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D014178:Translocation, Genetic; D016896:Treatment Outcome; D055815:Young Adult
D050660:Core Binding Factors