Core‐binding factor acute myeloid leukemia with t(8;21): Risk factors and a novel scoring system (I‐CBFit). (16th August 2018)

• Record Type: Journal Article
• Authors: Ustun, Celalettin; Morgan, Elizabeth; Moodie, Erica E. M.; Pullarkat, Sheeja; Yeung, Cecilia; Broesby‐Olsen, Sigurd; Ohgami, Robert; Kim, Young; Sperr, Wolfgang; Vestergaard, Hanne; Chen, Dong; Kluin, Philip M.; Dolan, Michelle; Mrózek, Krzysztof; Czuchlewski, David; Horny, Hans‐Peter; George, Tracy I.; Kristensen, Thomas Kielsgaard; Ku, Nam K.; Yi, Cecilia Arana; Møller, Michael Boe; Marcucci, Guido; Baughn, Linda; Schiefer, Ana‐Iris; Hilberink, J. R.; Pullarkat, Vinod; Shanley, Ryan; Kohlschmidt, Jessica; Coulombe, Janie; Salhotra, Amandeep; Soma, Lori; Cho, Christina; Linden, Michael A.; Akin, Cem; Gotlib, Jason; Hoermann, Gregor; Hornick, Jason; Nakamura, Ryo; Deeg, Joachim; Bloomfield, Clara D.; Weisdorf, Daniel; Litzow, Mark R.; Valent, Peter; Huls, Gerwin; Perales, Miguel‐Angel; Borthakur, Gautam;
• Is Part Of: Cancer medicine. Volume 7:Number 9(2018:Sep.)
• Page Start: 4447
• Page End: 4455
• Publication Date: 2018-08-16
• Subjects: acute myeloid leukemia -- core‐binding factor -- disease‐free survival -- KIT mutation -- predictive value -- relapse -- scoring system; 616.994005
• DOI: 10.1002/cam4.1733
• Languages: English
• ISSNs: 2045-7634

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). Abstract : CBF AML is relatively favorable AML; however, 30%‐40% of patients still relapse. There is no widely used scoring system to identify high‐risk patients. We here developed a novel scoring system (I‐CBFit) can differ patients with high risk of treatment failure from this with a lower risk score. This scoring system can be very useful to prognosticate and thus to choose right therapy (eg, personalize therapy) in CR1.