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Title: Prognostic Markers in Core-Binding Factor AML and Improved Survival with Multiple Consolidation Cycles of Intermediate/High-dose Cytarabine.
Austin Authors: Prabahran, Ashvind;Tacey, Mark A ;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
Department of Clinical Haematology and Bone Marrow, Transplant Royal Melbourne Hospital Victoria, Australia
Issue Date: 2-May-2018
Date: 2018-05-02
Publication information: 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.
DOI: 10.1111/ejh.13089
ORCID: 0000-0003-3135-0401
Journal: European journal of haematology
PubMed URL: 29719925
Type: Journal Article
Subjects: Acute Myeloid Leukaemia
Core binding factors
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