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Different prognostic effects of core-binding factor positive AML with Korean AML registry data

  • Ho-Jin Shin
  • Woo-Sung Min
  • Yoo Hong Min
  • June-Won Cheong
  • Je-Hwan Lee
  • In-Ho Kim
  • Dae Sik Hong
  • Jae-Sook Ahn
  • Hyeoung-Joon Kim
  • Won-Sik Lee
  • Chul Won Jung
  • Jun-Ho Jang
  • Young Park
  • Hee-Je KimEmail author
  • on behalf of the Korean Society of Hematology AML/MDS Working Party
Original Article

Abstract

Core-binding factor acute myeloid leukemia (CBF-AML) data in Asian countries has been rarely reported. We analyzed 392 patients with CBF-AML [281 with t(8;21), 111 with inv.(16)/t(16;16)] among data from 3041 patients with AML from the Korean AML Registry. Interestingly, del(9q) was less frequently detected in Korean than in German patients with t(8;21) (7.5% vs. 17%), and del(7q) was more frequently detected in Korean patients with inv(16). Overall survival (OS) was similar between patients in the first complete remission (CR) who received allogeneic (alloSCT) and autologous stem cell transplantation (ASCT) for CBF-AML. OS of t(8;21) patients was poor when undergoing alloSCT in second/third CR, while OS of inv(16) patients in second/third CR was similar to that in first CR. Patients with > 3-log reduction of RUNX1/RUNX1T1 qPCR had improved 3-year event-free survival (EFS) than those without (73.2% vs. 50.3%). Patients with t(8;21) AML with D816 mutation of the c-Kit gene showed inferior EFS and OS. These poor outcomes might be overcome by alloSCT. Multivariate analysis for OS in patients with t(8;21) revealed older age, > 1 course of induction chemotherapy to achieve CR, loss of sex chromosome, del(7q), and second/third CR or not in CR before SCT as independent prognostic variables. Especially, del(7q) is the most powerful prediction factor of poor outcomes, especially in patients with t(8;21) (hazard ratio, 27.23; P < 0.001). Further study is needed to clarify the clinical effect of cytogenetics and gene mutation in patients with CBF-AML, between Asian and Western countries.

Keywords

Acute myeloid leukemia Core-binding factor Stem cell transplantation Cytogenetics D816 mutation RUNX1/RUNX1T1 

Notes

Acknowledgments

We would like to thank all centers of the Korean Society of Hematology AML/MDS Working Party for their contributions to this analysis. This work was supported by clinical research grant from Pusan National University Hospital in 2018.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived off, because this study used retrospective data from the Korean AML registry, and there were no interventions in the patients.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ho-Jin Shin
    • 1
  • Woo-Sung Min
    • 2
  • Yoo Hong Min
    • 3
  • June-Won Cheong
    • 3
  • Je-Hwan Lee
    • 4
  • In-Ho Kim
    • 5
  • Dae Sik Hong
    • 6
  • Jae-Sook Ahn
    • 7
  • Hyeoung-Joon Kim
    • 7
  • Won-Sik Lee
    • 8
  • Chul Won Jung
    • 9
  • Jun-Ho Jang
    • 9
  • Young Park
    • 10
  • Hee-Je Kim
    • 2
    Email author
  • on behalf of the Korean Society of Hematology AML/MDS Working Party
  1. 1.Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research InstitutePusan National University HospitalBusanSouth Korea
  2. 2.Division of Hematology, Department of Internal Medicine, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, Leukemia Research Institute, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  3. 3.Division of Hematology, Department of Internal MedicineYonsei University College of MedicineSeoulSouth Korea
  4. 4.Department of Hematology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  5. 5.Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
  6. 6.Department of Internal Medicine, Soonchunhyang University Bucheon HospitalSoonchunhyang UniversityBucheonSouth Korea
  7. 7.Hematology-OncologyChonnam National University Hwasun HospitalHwasunSouth Korea
  8. 8.Department of Internal MedicineInje University Busan Paik HospitalBusanSouth Korea
  9. 9.Division of Hematology-Oncology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  10. 10.Division of Oncology and Hematology, Department of Internal MedicineKorea University Medical CenterSeoulSouth Korea

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