title: Acute myeloid leukemia with translocation (8;21) or inversion (16) in elderly patients treated with conventional chemotherapy: a collaborative study of the French CBF-AML intergroup.
abstract: OBJECTIVE
  Acute myeloid leukemia (AML) with translocation (t) (8;21) or inversion (inv) (16) is associated with a favorable prognosis when treated with intensive chemotherapy. In elderly patients, these AML types are rare, and intensive treatments are much less tolerated. We conducted a retrospective study to evaluate the characteristics and outcome of AML with t(8;21) or inv(16) in the elderly.
  
  
  METHODS
  Patients with t(8;21) or inv(16) AML who were age 60 years or older and who received at least one course of induction chemotherapy were included. Postremission therapy consisted of low-dose maintenance chemotherapy (n = 72) or intensive consolidation (n = 56).
  
  
  RESULTS
  A total of 147 patients were analyzed. The median age was 67 years. Sixty patients had t(8;21), and 87 patients had inv(16). A total of 129 patients achieved complete response (CR) after one or two induction courses (ie, 88% CR rate), and 15 patients (10%) died early (ie, during the 8 weeks after induction). During a median follow-up of 48 months, the 5-year probabilities of overall survival (OS) and leukemia-free survival (LFS) were 31% and 27%, respectively. Multivariate analysis showed a negative impact of high WBC, impaired performance status, and deletion (9q) on OS and LFS. Administration of intensive consolidation was associated with better LFS only in patients with t(8;21). In addition, the need for critical care during induction independently predicted lower LFS.
  
  
  CONCLUSIONS
  Because of a high CR rate, induction chemotherapy should be considered systematically for elderly patients who have AML with t(8;21) or inv(16). The high risk of relapse suggests that alternative strategies of postremission therapy are warranted.
authors.affiliation: Institut Paoli-Calmettes, 13009 Marseille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prébet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Boissel
authors.forename: Sarah
authors.initials: S
authors.lastname: Reutenauer
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Cahn
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pigneux
authors.forename: Bruno
authors.initials: B
authors.lastname: Quesnel
authors.forename: Francis
authors.initials: F
authors.lastname: Witz
authors.forename: Sylvain
authors.initials: S
authors.lastname: Thépot
authors.forename: Valérie
authors.initials: V
authors.lastname: Ugo
authors.forename: Christine
authors.initials: C
authors.lastname: Terre
authors.forename: Christian
authors.initials: C
authors.lastname: Recher
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Tavernier
authors.forename: Mathilde
authors.initials: M
authors.lastname: Hunault
authors.forename: Benjamin
authors.initials: B
authors.lastname: Esterni
authors.forename: Sylvie
authors.initials: S
authors.lastname: Castaigne
authors.forename: François
authors.initials: F
authors.lastname: Guilhot
authors.forename: Hervé
authors.initials: H
authors.lastname: Dombret
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D007446:Chromosome Inversion; D002885:Chromosomes, Human, Pair 16 / Q000235:genetics*; D002891:Chromosomes, Human, Pair 21 / Q000235:genetics*; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics*; D050660:Core Binding Factors / Q000235:genetics; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014178:Translocation, Genetic; D016896:Treatment Outcome
chemical_list: D050660:Core Binding Factors