The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations

Authors: Appelbaum, Frederick R.¹; Kopecky, Kenneth J.¹; Tallman, Martin S.²; Slovak, Marilyn L.³; Gundacker, Holly M.¹; Kim, Haesook T.⁴; Dewald, Gordon W.⁵; Kantarjian, Hagop M.⁶; Pierce, Sherry R.⁶; Estey, Elihu H.⁶

Source: British Journal of Haematology, Volume 135, Number 2, October 2006 , pp. 165-173(9)

Publisher: Wiley-Blackwell

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Abstract:

Summary

To better understand the spectrum of adult acute myeloid leukaemia (AML) associated with core binding factor (CBF) translocations, 370 patients with newly diagnosed CBF-associated AML were analysed. Patients' age ranged from 16-83 years (median 39 years) with a slight male predominance (55%); 53% had inv(16); 47% had t(8;21). Patients with t(8;21) tended to be younger (P = 0·056), have lower peripheral blood white cell counts (P < 0·0001) and were more likely to have additional cytogenetic abnormalities (P < 0·0001). Loss of sex chromosome, del(9q) and complex abnormalities were more common among patients with t(8;21), while +22 and +21 were more common with inv(16). Overall, 87% [95% confidence interval (CI) 83-90%] of patients achieved complete response (CR) with no difference between t(8;21) and inv(16); however, the CR rate was lower in older patients due to increased resistant disease and early deaths. Ten-year overall survival (OS) was 44% (95% CI 39-50%) and, in multivariate analysis, was shorter with increasing age (P < 0·0001), increased peripheral blast percentage (P = 0·0006), in patients with complex cytogenetic abnormalities in addition to the CBF translocation (P = 0·021), and in patients with t(8;21) (P = 0·025). OS was superior in patients who received regimens with high-dose cytarabine, a combination of fludarabine and intermediate-dose cytarabine, or haematopoietic cell transplantation.

Keywords: acute myeloid leukaemia; core binding factor leukaemia; cytogenetics of leukaemia; leukaemia treatment; adult leukaemia

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2141.2006.06276.x

Affiliations: 1: Southwest Oncology Group Statistical Center, Seattle, WA 2: Northwestern University Feinberg School of Medicine, Chicago, IL 3: City of Hope National Medical Center, Duarte, CA 4: Dana-Farber Cancer Institute, Boston, MA 5: Mayo Clinic, Rochester, MN 6: M.D. Anderson Cancer Center, Houston, TX, USA

Publication date: 2006-10-01

The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations

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