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|Title:||Prognostic Markers in Core-Binding Factor AML and Improved Survival with Multiple Consolidation Cycles of Intermediate/High-dose Cytarabine.|
|Authors:||Prabahran, Ashvind;Tacey, Mark;Fleming, Shaun;Wei, Andrew;Tate, Courtney;Marlton, Paula;Wight, Joel C;Grigg, Andrew P ;Tuckfield, Annabel;Szer, Jeff;Ritchie, David;Chee, Lynette|
|Affiliation:||Melbourne Epicentre Royal Melbourne Hospital Victoria, Australia|
The Alfred Hospital Victoria, Australia
Princes Alexandra Hospital Queensland, Australia
Austin Health, Heidelberg, Victoria, Australia
Department of Clinical Haematology and Bone Marrow, Transplant Royal Melbourne Hospital Victoria, Australia
|Citation:||European journal of haematology 2018; online first: 2 May|
|Abstract:||Core-binding factor acute myeloid leukaemia (CBF AML) defined by t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22) has a favourable prognosis, however 30-40% of patients still relapse after chemotherapy. We sought to evaluate risk factors for relapse in a de novo CBF AML cohort. A retrospective review of patients from 4 Australian tertiary centres from 2001-2012, comprising 40 t(8;21) and 30 inv(16) AMLs. Multivariate analysis identified age (p=0.032) and WCC>40 (p=0.025) as significant predictors for inferior OS and relapse respectively. Relapse risk was higher in the inv(16) group vs the t(8;21) group (57% vs 18%, HR 4.31, 95% CI: 1.78-10.42, p=0.001). Induction therapy had no bearing on OS or relapse free survival (RFS) however, consolidation treatment with >3 cycles of intermediate/high dose cytarabine improved OS (p=0.035) and relapse-free survival (RFS) (p=0.063). 5 patients demonstrated post-treatment stable q PCR positivity without relapse. (1)>3 consolidation cycles of intermediate/ high-dose cytarabine improves patient outcomes. (2)Age and inv(16) CBF AML subtype are predictors of inferior OS and RFS respectively. (3)Stable low-level MRD by qPCR does not predict relapse. (4)Similar OS in the inv(16) cohort compared to the t(8;21) cohort, despite a higher relapse rate, confirms salvageability of relapsed disease. This article is protected by copyright. All rights reserved.|
|Subjects:||Acute Myeloid Leukaemia|
Core binding factors
|Appears in Collections:||Journal articles|
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