title: Core-binding factor acute myeloid leukemia in first relapse: a retrospective study from the French AML Intergroup.
abstract: Although core-binding factor-acute myeloid leukemia (CBF-AML) (t[8;21] or inv[16]/t[16;16]) represents a favorable cytogenetic AML subgroup, 30% to 40% of these patients relapse after standard intensive chemotherapy. The encouraging results of gemtuzumab ozogamicin (GO) in newly diagnosed AML, and particularly in CBF-AML, incited us to retrospectively investigate the impact of GO-based salvage in these patients. We retrospectively analyzed the outcome of 145 patients with CBF-AML (59 t[8;21], 86 inv[16]/t[16;16]) in first relapse. As salvage, 48 patients received GO-based chemotherapy and 97 patients received conventional chemotherapy. Median age was 43 years (range, 16-76). Median first complete remission duration was 12.1 months (range, 2.1-93.6). Overall, second complete remission (CR2) rate was 88%. With a median follow-up from relapse of 3.5 years, the estimated 5-year disease-free survival (DFS) was 50% and 5-year overall survival (OS) was 51%. Older age and shorter first complete remission duration was associated with a shorter OS. Patients treated with GO had similar CR2 rate but significantly higher 5-year DFS (68% vs 42%; P = .05) and OS (65% vs 44%; P = .02). In multivariate analysis, GO salvage was still associated with a significant benefit in DFS and OS. In the 78 patients who received allogeneic hematopoietic stem cell transplantation in CR2, GO before transplant significantly improved posttransplant DFS and OS without excess of treatment-related mortality.
authors.affiliation: Department of Hematology, EA-3518, Paris 7 University, Hôpital Saint-Louis, Paris, France;
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Hospital
authors.affiliation: Department of Hematology, Institut Paoli-Calmettes, Marseille, France;
authors.forename: Thomas
authors.initials: T
authors.lastname: Prebet
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire Purpan, Toulouse, France;
authors.forename: Sarah
authors.initials: S
authors.lastname: Bertoli
authors.affiliation: Department of Hematology, Hôpital Edouard Herriot, Lyon, France;
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
authors.affiliation: Department of Hematology, Institut de Cancérologie de la Loire, Saint Etienne, France;
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Tavernier
authors.affiliation: Department of Hematology, Hôpital Avicenne, Bobigny, France;
authors.forename: Thorsten
authors.initials: T
authors.lastname: Braun
authors.affiliation: Department of Hematology, Hôpital Henri Mondor, Créteil, France;
authors.forename: Cécile
authors.initials: C
authors.lastname: Pautas
authors.affiliation: Department of Hematology, Hôpital de Brabois, Nancy, France;
authors.forename: Aurore
authors.initials: A
authors.lastname: Perrot
authors.affiliation: Department of Hematology, Hôpital Hautepierre, Strasbourg, France;
authors.forename: Bruno
authors.initials: B
authors.lastname: Lioure
authors.affiliation: Department of Hematology, Centre Hospitalier de Versailles, Versailles, France;
authors.forename: Philippe
authors.initials: P
authors.lastname: Rousselot
authors.affiliation: Department of Hematology, Hôpital Cochin, Paris, France;
authors.forename: Jérôme
authors.initials: J
authors.lastname: Tamburini
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire Nice, Nice, France;
authors.forename: Thomas
authors.initials: T
authors.lastname: Cluzeau
authors.affiliation: Department of Hematology, Hôpital d'Instruction des Armées Percy, Clamart, France;
authors.forename: Johanna
authors.initials: J
authors.lastname: Konopacki
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France;
authors.forename: Edouard
authors.initials: E
authors.lastname: Randriamalala
authors.affiliation: Department of Hematology, Hôpital Claude Huriez, Lille, France;
authors.forename: Céline
authors.initials: C
authors.lastname: Berthon
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire Limoges, Limoges, France;
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gourin
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire Purpan, Toulouse, France;
authors.forename: Christian
authors.initials: C
authors.lastname: Recher
authors.affiliation: Department of Hematology, Clinique Universitaire d'Hématologie, Centre Hospitalier Universitaire Michallon, Grenoble, France; and.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Cahn
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire et INSERM U892-Centre National de la Recherche Scientifique Unité Mixte de Recherche 6299, Angers, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Ifrah
authors.affiliation: Department of Hematology, EA-3518, Paris 7 University, Hôpital Saint-Louis, Paris, France;
authors.forename: Hervé
authors.initials: H
authors.lastname: Dombret
authors.affiliation: Department of Hematology, EA-3518, Paris 7 University, Hôpital Saint-Louis, Paris, France;
authors.forename: Nicolas
authors.initials: N
authors.lastname: Boissel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D007446:Chromosome Inversion; D002877:Chromosomes, Human / Q000235:genetics*; D050660:Core Binding Factors; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France; D016298:Hematopoietic Cell Growth Factors; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D050660:Core Binding Factors; D016298:Hematopoietic Cell Growth Factors