Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia

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• 作者：Sung-Soo Park ; Jae-Ho Yoon ; Hee-Je Kim ; ^{cumckim@catholic.ac.kr} ; Young-Woo Jeon ; Sung-Eun Lee ; Byung-Sik Cho ; Ki-Seong Eom ; Yoo-Jin Kim ; Seok Lee ; Chang-Ki Min ; Seok-Goo Cho ; Dong-Wook Kim ; Jong-Wook Lee ; Woo-Sung Min
• 关键词：Central nervous system ; c-kit ; Core-binding factor ; Extramedullary ; Hematopoietic cell transplantation
• 刊名：Clinical Lymphoma Myeloma and Leukemia
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：17
• 期：1
• 页码：38-45.e2
• 全文大小：485 K
• 卷排序：17

文摘

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 MethodsWe 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).ResultsCentral nervous system was the most frequently involved site (70.6%). EM-positive t(8;21) was associated with age ≤ 45 years, leukocytosis (≥ 30 × 109/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.ConclusionEM-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).