title: Prognosis of patients with core binding factor acute myeloid leukemia after first relapse.
abstract: Core binding factor acute myeloid leukemia is known to have a favorable prognosis, however, there have been no detailed analyses on prognostic factors after first relapse. Using a nationwide database, we retrospectively analyzed core binding factor acute myeloid leukemia patients who relapsed after being treated with chemotherapy alone during their first complete remission. Of a total of 397 patients who were diagnosed with core binding factor acute myeloid leukemia, 208 experienced a first relapse, and analyses were performed in 139 patients for whom additional data were available. In the entire cohort, the overall survival rate after relapse was 48% at 3 years. By multivariate analysis, younger age at diagnosis, a longer interval before relapse, and inv(16) were shown to be independently associated with better survival after relapse. Although there was no significant difference in survival after relapse between patients who underwent allogeneic hematopoietic cell transplantation and those who did not in the overall series of relapsed patients, we found that transplantation significantly improved survival among patients who had t(8;21) (54% versus 26% at 3 years, P=0.002). In addition, among patients with t(8;21), those who had different cytogenetics at relapse had a significantly improved survival after transplantation, while those who had same cytogenetics did not. We showed that the prognosis differs significantly and optimal treatment strategies may vary between groups of patients with core binding factor acute myeloid leukemia with different cytogenetic profiles at relapse. These findings may help to guide therapeutic decisions after first relapse.
authors.affiliation: skurosaw@ncc.go.jp.
authors.forename: Saiko
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyawaki
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
authors.forename: Toru
authors.initials: T
authors.lastname: Sakura
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Moriuchi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Sano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yasumoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatanaka
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Yanada
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nawa
authors.forename: Jin
authors.initials: J
authors.lastname: Takeuchi
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Shin
authors.initials: S
authors.lastname: Fujisawa
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Shibayama
authors.forename: Ikuo
authors.initials: I
authors.lastname: Miura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D050660:Core Binding Factors; D016208:Databases, Factual; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000639:trends; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D050660:Core Binding Factors