Outcomes of Patients With Relapsed Core Binding Factor-Positive Acute Myeloid Leukemia
Maliha Khan1, Jorge Cortes1, Wei Qiao2
1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Clinical Lymphoma, Myeloma & Leukemia
|November 7, 2017
Summary
Outcomes for core binding factor acute myeloid leukemia (CBF-AML) patients in first relapse are poor, especially for those with t(8;21) genetic group. Stem cell transplant improved survival, but further clinical trials are needed for better results.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Core binding factor acute myeloid leukemia (CBF-AML) is a distinct subtype of AML.
- Relapse in CBF-AML patients often leads to poor prognosis.
- Identifying prognostic factors is crucial for improving patient outcomes.
Purpose of the Study:
- To identify factors associated with survival in patients with CBF-AML experiencing their first relapse.
- To compare outcomes between different cytogenetic groups within relapsed CBF-AML.
Main Methods:
- Retrospective analysis of 92 CBF-AML patients in first relapse (1990-2014).
- Univariate and multivariate Cox proportional hazards regression models were used.
- Clinical, demographic, and cytogenetic parameters were analyzed for their association with overall survival.
Main Results:
- The t(8;21) cytogenetic group had significantly shorter median survival (9 months) compared to the inv(16) group (15.6 months).
- Increased age, high white blood cell count, t(8;21) genetics, and high bone marrow blast percentage were associated with poor survival.
- Stem cell transplant was linked to improved survival, while additional cytogenetic aberrations at relapse did not significantly impact outcomes.
- Multivariate analysis confirmed t(8;21) as an independent predictor of increased mortality risk (HR 1.802, P = .02).
Conclusions:
- Patients with relapsed CBF-AML have a median survival of less than 1.5 years, with worse outcomes observed in the t(8;21) group.
- Despite current treatments, outcomes remain challenging, highlighting the need for novel therapeutic strategies.
- Dedicated clinical trials are essential to improve survival rates for all patients with relapsed CBF-AML.
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