title: Re-analysis of the outcomes of post-remission therapy for acute myeloid leukemia with core binding factor according to years of patient enrollment.
abstract: 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).
authors.affiliation: Pusan National University Medical School, Pusan National University Hospital, Busan, Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Hyeoung-Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Hwi-Joong
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Deog-Yeon
authors.initials: DY
authors.lastname: Jo
authors.forename: Young Don
authors.initials: YD
authors.lastname: Joo
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Ahn
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Je-hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Seong-jun
authors.initials: SJ
authors.lastname: Choi
authors.forename: Jung-hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Sung Hwa
authors.initials: SH
authors.lastname: Bae
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Hong
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Zang
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Kim
authors.forename: Jung Lim
authors.initials: JL
authors.lastname: Lee
authors.forename: Soo Mee
authors.initials: SM
authors.lastname: Bang
mesh_terms: 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
chemical_list: D050660:Core Binding Factors; D003561:Cytarabine; D003630:Daunorubicin