Prognosis of patients with core binding factor acute myeloid leukemia after first relapse
Autor: | Saiko Kurosawa, Shuichi Miyawaki, Takuhiro Yamaguchi, Heiwa Kanamori, Toru Sakura, Yukiyoshi Moriuchi, Fumiaki Sano, Takeshi Kobayashi, Atsushi Yasumoto, Kazuo Hatanaka, Masamitsu Yanada, Yuichiro Nawa, Jin Takeuchi, Yukinori Nakamura, Shin Fujisawa, Hirohiko Shibayama, Ikuo Miura, Takahiro Fukuda |
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Jazyk: | angličtina |
Rok vydání: | 2013 |
Předmět: | |
Zdroj: | Haematologica, Vol 98, Iss 10 (2013) |
Druh dokumentu: | article |
ISSN: | 0390-6078 1592-8721 |
DOI: | 10.3324/haematol.2012.078030 |
Popis: | 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. |
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