Allogeneic stem cell transplant may improve the outcome of adult patients with inv(16) acute myeloid leukemia in first complete remission with poor molecular responses to chemotherapy. Issue 11 (2nd November 2015) - Qin, Ya-Zhen
Abstract : Eighty-six adult patients with inv(16) acute myeloid leukemia (AML) in first complete remission (CR1) were serially monitored for CBFB–MYH11 transcript levels during the early courses of chemotherapy. Fifty-seven and 29 of them received chemotherapy/autologous stem cell transplant (SCT) and allogeneic (allo-)SCT after second consolidation, respectively. For patients receiving chemotherapy/autologous SCT, the sole independent adverse prognostic factor for the cumulative incidence of relapse (CIR), disease-free survival (DFS) and overall survival (OS) was a CBFB–MYH11 level > 0.2% after course 2 consolidation ( p = 0.003, 0.003 and 0.031), which was used to define a poor molecular response (MR). Allo-SCT significantly decreased the 3-year CIR and increased the DFS and OS of patients with a poor MR ( p < 0.0001, 0.0001 and 0.045) but did not improve the outcome of patients with good MR (all p > 0.05) compared with chemotherapy/autologous SCT. Therefore, allo-SCT could improve the outcome of adult patients with inv(16) AML in CR1 with a poor MR during the early courses of chemotherapy.