Core binding factor acute myeloid leukemia: the impact of age, leukocyte count, molecular findings, and minimal residual disease
Por:
Hoyos, M, Nomdedeu, JF, Esteve, J, Duarte, R, Ribera, JM, Llorente, A, Escoda, L, Bueno, J, Tormo, M, Gallardo, D, de Llano, MPQ, Marti, JM, Aventin, A, Mangues, R, Brunet, S, Sierra, J
Publicada:
1 sep 2013
Resumen:
Purpose Most patients with acute myeloid leukemia (AML) and genetic rearrangements involving the core binding factor (CBF) have favorable prognosis. In contrast, a minority of them still have a high risk of leukemia recurrence. This study investigated the adverse features of CBFAML that could justify investigational therapeutic approaches.
Patients and methods One hundred and fifty patients (median age 42yr, range 16-69) with CBFAML (RUNX1-RUNX1T1 n=74; CBFB-MYH11 n=76) were prospectively enrolled into two consecutive CETLAM protocols at 19 Spanish institutions. Main clinic and biologic parameters were analyzed in the whole series. In non-selected cases with available DNA samples, the impact of molecular characterization and minimal residual disease (MRD) was also studied.
Results Overall, complete remission (CR) rate was 89% (94% in 50yr old and 72% in >50yr, P=0.002). At 5yr, cumulative incidence of relapse (CIR) was 26 +/- 1%, disease-free survival (DFS) 62 +/- 6%, and overall survival (OS) 66 +/- 4%. In multivariate analyses, leukocyte count above 20x10(9)/L, BAALC over-expression, and high copy numbers of RUNX1-RUNXT1 or CBFB-MYH11 after induction chemotherapy (CT) led to increased relapse rate. Regarding OS, age >50yr, leukocyte count above 20x10(9)/L, and increased MN1 expression were adverse features.
Conclusion Age, leukocyte counts, BAALC, and MN1 gene expressions as well as high copy numbers of RUNX1-RUNXT1 or CBFB-MYH11 after induction chemotherapy are useful tools to predict the outcome and should be considered for risk-adapted therapy.
Filiaciones:
Hoyos, M:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Univ Barcelona, Barcelona, Spain
Nomdedeu, JF:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Esteve, J:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Duarte, R:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Ribera, JM:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Llorente, A:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Escoda, L:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Bueno, J:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Tormo, M:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Gallardo, D:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
de Llano, MPQ:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Marti, JM:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Aventin, A:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Mangues, R:
Networking Res Ctr Bioengn Biomat & Nanomed CIBER, Barcelona, Spain
Brunet, S:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Sierra, J:
Univ Autonoma Barcelona, Spanish Canc Network RTICC, Hosp Santa Creu & St Pau, Spanish CETLAM Grp,Inst Invest Biomed St Pau, E-08193 Barcelona, Spain
Banc Sang & Teixits Catalunya, Barcelona, Spain
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