CHARACTERISTICS AND OUTCOME OF T(8;21)-POSITIVE CHILDHOOD ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION'S EXPERIENCE

Abstract

Objective: Compared with other cytogenetic acute myeloid leukemia (AML) groups, patients with core-binding factor AML (CBF-AML) are considered as a favorable AML risk group based on their high remission rate and survival probabilities. However, up to 30-40% of these patients can still relapse after standard intensive induction and consolidation chemotherapy. Methodology: From 2004 to 2020, 147 AML patients reviewed. Ten of 147 patients were followed up with t(8;21) chromosomal anomaly. The t(8;21)(q22;q22) was detected by reverse transcription polymerase chain reaction (RT-PCR) and/or floresan in situ hibridizasyon (FISH). We analyzed patients’ demographic data: sex, white blood cell count at diagnosis, central nervous system status, additional cytogenetic anomaly and recurrence rates, stem cell transplant status and survival rates. Results: Two of 10 patients were female. The median age was 10 years (3-17 years). Median followup was 36 months (2-114 months). The mean white blood cell count of 10 patients was 21.5 (× 109/l) at diagnosis. One out of 10 patients had granulocytic sarcoma and 2 had central nervous system involvement. Additional cytogenetic anomalies were detected in 90% of the patients, of which 2 relapsed and 3 died. One patient received hematopoietic stem cell transplantation and died because of HSCT complications. Conclusion: Recent studies show that CBF-AML includes different groups with different clinical outcomes. We found that 50% of our patients achieved complete remission and 50% experienced relapsed disease or death. After we were able to monitor the t(8;21) level with RT-PCR, we diagnosed relapsed disease in 1 patient with additional cytogenetic anomaly. RT-PCR is essential for optimal handling of these patients to predict patients’ relapse risk and to detect minimal residual disease.