Re-analysis of the outcomes of post-remission therapy for acute myeloid leukemia with core binding factor according to years of patient enrollment.
OBJECTIVE
The purpose of this study was to re-evaluate post-remission therapy outcomes after first remission according to years of patient enrollment in patients with core binding factor acute myeloid leukaemia.


METHODS
We conducted a retrospective study on 138 patients aged less than 60 years diagnosed with core binding factor acute myeloid leukaemia between 1994 and 2006, comparing allogeneic stem cell transplantation and high-dose cytarabine chemotherapy as post-remission treatment options after the first remission.


RESULTS
The 5-year probabilities of disease-free survival and overall survival were not different between allogeneic stem cell transplantation and high-dose cytarabine groups. However, 3-year probabilities of disease-free survival (86.7% vs. 67.0%) and overall survival (90.0% vs. 67.3%) showed a trend towards improvement in the allogeneic stem cell transplantation group compared with the high-dose cytarabine group in cohort after 2003 (2003-2006), whereas outcomes were not different in cohort before 2003 (1994-2002). Especially, 3-year probabilities of disease-free survival (95.2% vs. 59.3%, P = 0.008) and overall survival (95.2% vs. 59.6%, P = 0.032) of allogeneic stem cell transplantation group were significantly better than high-dose cytarabine group in cohort after 2003 of acute myeloid leukaemia patients with t(8;21). The relative risk of overall survival with allogeneic stem cell transplantation, compared with high-dose cytarabine chemotherapy, was significantly improved in the cohort after 2003 (0.33; 95% CI, 0.07-1.48) when compared with that before 2003 (1.92; 95% CI, 0.77-4.82). In multivariate analysis in cohort after 2003, allogeneic stem cell transplantation as post-remission therapy was associated with better disease-free survival.


CONCLUSIONS
Allogeneic stem cell transplantation is currently the more effective post-remission therapy than it was prior to 2003 for core binding factor acute myeloid leukaemia achieving first remission. On the contrary to previous findings, allogeneic stem cell transplantation provides significantly improved outcomes than high-dose cytarabine chemotherapy in acute myeloid leukaemia with t(8;21).
Shin
Ho-Jin
HJ
Pusan National University Medical School, Pusan National University Hospital, Busan, Korea.
Kim
Hyeoung-Joon
HJ
Sohn
Sang Kyun
SK
Min
Yoo Hong
YH
Won
Jong-Ho
JH
Kim
Inho
I
Yoon
Hwi-Joong
HJ
Lee
Jae Hoon
JH
Jo
Deog-Yeon
DY
Joo
Young Don
YD
Jung
Chul Won
CW
Lee
Kyoo-Hyung
KH
Chung
Joo Seop
JS
Ahn
Jin Seok
JS
Kim
Seok Jin
SJ
Lee
Je-hwan
JH
Choi
Seong-jun
SJ
Lee
Jung-hee
JH
Bae
Sung Hwa
SH
Hong
Dae Sik
DS
Zang
Dae Young
DY
Kim
Sun Hee
SH
Lee
Jung Lim
JL
Bang
Soo Mee
SM
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D050660:Core Binding Factors / Q000378:metabolism*; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use; D003630:Daunorubicin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D033581:Stem Cell Transplantation; D015996:Survival Rate; D055815:Young Adult
D050660:Core Binding Factors; D003561:Cytarabine; D003630:Daunorubicin