[Characteristic clinical features and treatment of acute myelocytic leukemia with 8;21 translocation]

From 1981 to 1992 forty acute myelocytic leukemia patients with the 8;21 translocation [t (8;21) AML] were treated with intensive chemotherapy and radiotherapy. Their ages ranged from 12 to 81 years at the time of diagnosis. The 8;21 translocation occurred in 13.8% of all patients with AML. Of the 40 t (8;21) AML patients, 10 (25.0%) developed extramedullary tumors at sites such as mastoid, orbit and temporal region. This occurred more commonly among younger patients. Thirty-eight of the 40 patients (95.0%) achieved complete remission (CR). Of these 38 patients, 36 received post-remission chemotherapy. Since 1984, 29 consecutive patients have been given cranial irradiation, 24Gy, for prophylaxis and treatment of leukemic tumors. The twelve years remission and survival rate for this group are 68.3% and 62.1%, respectively. Of the 38 patients achieving CR, in those over 30 years of age at the time of diagnosis, 19 of 23 remain in first remission, whereas in the younger patients 5 of 13 have relapsed. The duration of CR of patients who developed extramedullary tumors was shorter than that of patients without such tumors. A second CR was achieved in 7 of 9 recurrent cases. Three remain in remission 21, 45, and 117 months after chemotherapy and allogeneic bone marrow transplantation. We attribute the very long duration of CR in our patients with t (8;21) AML to the intensive post remission therapy. Younger patients with t (8;21) AML and/or extramedullary tumors probably should receive early bone marrow transplantation.