Cancer Medicine (Sep 2018)
Core‐binding factor acute myeloid leukemia with t(8;21): Risk factors and a novel scoring system (I‐CBFit)
- Celalettin Ustun,
- Elizabeth Morgan,
- Erica E. M. Moodie,
- Sheeja Pullarkat,
- Cecilia Yeung,
- Sigurd Broesby‐Olsen,
- Robert Ohgami,
- Young Kim,
- Wolfgang Sperr,
- Hanne Vestergaard,
- Dong Chen,
- Philip M. Kluin,
- Michelle Dolan,
- Krzysztof Mrózek,
- David Czuchlewski,
- Hans‐Peter Horny,
- Tracy I. George,
- Thomas Kielsgaard Kristensen,
- Nam K. Ku,
- Cecilia Arana Yi,
- Michael Boe Møller,
- Guido Marcucci,
- Linda Baughn,
- Ana‐Iris Schiefer,
- J. R. Hilberink,
- Vinod Pullarkat,
- Ryan Shanley,
- Jessica Kohlschmidt,
- Janie Coulombe,
- Amandeep Salhotra,
- Lori Soma,
- Christina Cho,
- Michael A. Linden,
- Cem Akin,
- Jason Gotlib,
- Gregor Hoermann,
- Jason Hornick,
- Ryo Nakamura,
- Joachim Deeg,
- Clara D. Bloomfield,
- Daniel Weisdorf,
- Mark R. Litzow,
- Peter Valent,
- Gerwin Huls,
- Miguel‐Angel Perales,
- Gautam Borthakur
Affiliations
- Celalettin Ustun
- Division of Hematology, Oncology and Transplantation Department of Medicine University of Minnesota Minneapolis Minnesota
- Elizabeth Morgan
- Department of Pathology Harvard Medical School Brigham and Women's Hospital Boston Massachusetts
- Erica E. M. Moodie
- Department of Epidemiology, Biostatistics & Occupational Health McGill University Montreal Quebec Canada
- Sheeja Pullarkat
- Department of Pathology University of California Los Angeles California
- Cecilia Yeung
- Fred Hutchinson Cancer Research Center Seattle Washington
- Sigurd Broesby‐Olsen
- Department of Dermatology and Allergy Centre Odense Research Center for Anaphylaxis Odense Denmark
- Robert Ohgami
- Department of Pathology Stanford University Stanford California
- Young Kim
- Department of Pathology City of Hope National Medical Center Duarte California
- Wolfgang Sperr
- Division of Hematology & Hemostaseology Ludwig Boltzmann Cluster Oncology Department of Internal Medicine I Medical University of Vienna Vienna Austria
- Hanne Vestergaard
- Mastocytosis Center Odense University Hospital Odense Denmark
- Dong Chen
- Department of Pathology Mayo Clinic Rochester Minnesota
- Philip M. Kluin
- Department of Pathology and Medical Biology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Michelle Dolan
- Department of Laboratory Medicine and Pathology University of Minnesota Minneapolis Minnesota
- Krzysztof Mrózek
- The Ohio State University Comprehensive Cancer Center Columbus Ohio
- David Czuchlewski
- Department of Pathology University of New Mexico Albuquerque New Mexico
- Hans‐Peter Horny
- Institute of Pathology Ludwig‐Maximilians‐University Munich Germany
- Tracy I. George
- Department of Pathology University of New Mexico Albuquerque New Mexico
- Thomas Kielsgaard Kristensen
- Mastocytosis Center Odense University Hospital Odense Denmark
- Nam K. Ku
- Department of Pathology University of California Los Angeles California
- Cecilia Arana Yi
- Department of Pathology University of New Mexico Albuquerque New Mexico
- Michael Boe Møller
- Mastocytosis Center Odense University Hospital Odense Denmark
- Guido Marcucci
- Division of Hematology and HCT City of Hope Duarte California
- Linda Baughn
- Department of Pathology Mayo Clinic Rochester Minnesota
- Ana‐Iris Schiefer
- Department of Pathology Medical University of Vienna Vienna Austria
- J. R. Hilberink
- Department of Pathology and Medical Biology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Vinod Pullarkat
- Division of Hematology and HCT City of Hope Duarte California
- Ryan Shanley
- Biostatistics and Bioinformatics University of Minnesota Minneapolis Minnesota
- Jessica Kohlschmidt
- The Ohio State University Comprehensive Cancer Center Columbus Ohio
- Janie Coulombe
- Department of Epidemiology, Biostatistics & Occupational Health McGill University Montreal Quebec Canada
- Amandeep Salhotra
- Division of Hematology and HCT City of Hope Duarte California
- Lori Soma
- Fred Hutchinson Cancer Research Center Seattle Washington
- Christina Cho
- Department of Medicine Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York NY
- Michael A. Linden
- Department of Laboratory Medicine and Pathology University of Minnesota Minneapolis Minnesota
- Cem Akin
- Department of Pathology Harvard Medical School Brigham and Women's Hospital Boston Massachusetts
- Jason Gotlib
- Stanford Cancer Institute School of Medicine Stanford University Stanford California
- Gregor Hoermann
- Department of Laboratory Medicine Medical University of Vienna Vienna Austria
- Jason Hornick
- Department of Pathology Harvard Medical School Brigham and Women's Hospital Boston Massachusetts
- Ryo Nakamura
- Division of Hematology and HCT City of Hope Duarte California
- Joachim Deeg
- Fred Hutchinson Cancer Research Center Seattle Washington
- Clara D. Bloomfield
- The Ohio State University Comprehensive Cancer Center Columbus Ohio
- Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation Department of Medicine University of Minnesota Minneapolis Minnesota
- Mark R. Litzow
- Department of Internal Medicine and Division of Hematology Mayo Clinic Rochester Minnesota
- Peter Valent
- Division of Hematology & Hemostaseology Ludwig Boltzmann Cluster Oncology Department of Internal Medicine I Medical University of Vienna Vienna Austria
- Gerwin Huls
- Department of Hematology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Miguel‐Angel Perales
- Department of Medicine Adult Bone Marrow Transplant Service Memorial Sloan Kettering Cancer Center New York NY
- Gautam Borthakur
- Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas
- DOI
- https://doi.org/10.1002/cam4.1733
- Journal volume & issue
-
Vol. 7,
no. 9
pp. 4447 – 4455
Abstract
Abstract Background Although the prognosis of core‐binding factor (CBF) acute myeloid leukemia (AML) is better than other subtypes of AML, 30% of patients still relapse and may require allogeneic hematopoietic cell transplantation (alloHCT). However, there is no validated widely accepted scoring system to predict patient subsets with higher risk of relapse. Methods Eleven centers in the US and Europe evaluated 247 patients with t(8;21)(q22;q22). Results Complete remission (CR) rate was high (92.7%), yet relapse occurred in 27.1% of patients. A total of 24.7% of patients received alloHCT. The median disease‐free (DFS) and overall (OS) survival were 20.8 and 31.2 months, respectively. Age, KIT D816V mutated (11.3%) or nontested (36.4%) compared with KIT D816V wild type (52.5%), high white blood cell counts (WBC), and pseudodiploidy compared with hyper‐ or hypodiploidy were included in a scoring system (named I‐CBFit). DFS rate at 2 years was 76% for patients with a low‐risk I‐CBFit score compared with 36% for those with a high‐risk I‐CBFit score (P < 0.0001). Low‐ vs high‐risk OS at 2 years was 89% vs 51% (P < 0.0001). Conclusions I‐CBFit composed of readily available risk factors can be useful to tailor the therapy of patients, especially for whom alloHCT is not need in CR1 (ie, patients with a low‐risk I‐CBFit score).
Keywords
- acute myeloid leukemia
- core‐binding factor
- disease‐free survival
- KIT mutation
- predictive value
- relapse