Park, Sung-Soo; Yoon, Jae-Ho; Kim, Hee-Je; Jeon, Young-Woo; Lee, Sung-Eun; Cho, Byung-Sik; Eom, Ki-Seong; Kim, Yoo-Jin; Lee, Seok; Min, Chang-Ki; Cho, Seok-Goo; Kim, Dong-Wook; Lee, Jong-Wook; Min, Woo-Sung
Clinical lymphoma, myeloma & leukemia
2017Jan ; 17 ( 1 ) :38-45.e2.
PMID : 27742476
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Park, Sung-Soo -
Yoon, Jae-Ho -
Kim, Hee-Je -
Jeon, Young-Woo -
Lee, Sung-Eun -
Cho, Byung-Sik -
Eom, Ki-Seong -
Kim, Yoo-Jin -
Lee, Seok -
Min, Chang-Ki -
Cho, Seok-Goo -
Kim, Dong-Wook -
Lee, Jong-Wook -
Min, Woo-Sung -
ABSTRACT
BACKGROUND: Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. PATIENTS AND
METHODS: We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis. EM involvement was evaluated only when a patient showed suspicious signs or symptoms. All EM-positive patients were treated according to a strategy based on allogeneic hematopoietic cell transplantation (allo-HCT).
RESULTS: Central nervous system was the most frequently involved site (70.6%). EM-positive t(8;21) was associated with age???45 years, leukocytosis (??30?× 10(9)/L), and c-kit mutation compared to EM-negative t(8;21) in multivariate analysis. After intensive chemotherapy with or without local therapy, high-risk t(8;21) AML including EM-positive t(8;21) underwent allo-HCT for postremission therapy. Three-year OS (52.3% vs. 60.0%, P?= .658) and event-free survival (51.5% vs. 58.0%, P?= .496) were not different between the 2 groups. The subgroup of patients who underwent allo-HCT also showed similar outcomes. CONCLUSION: EM-positive t(8;21) was associated with young age, leukocytosis, and c-kit mutation, and central nervous system was frequently involved. Allo-HCT resulted in good outcomes in EM-positive t(8;21). CI - Copyright ??2016 Elsevier Inc. All rights reserved.
Central nervous system; Core-binding factor; Extramedullary; Hematopoietic cell transplantation; c-kit
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