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

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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.

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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.

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Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea

    Ho-Jin Shin

  2. Division of Hematology, Department of Internal Medicine, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, Leukemia Research Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea

    Woo-Sung Min & Hee-Je Kim

  3. Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Yoo Hong Min & June-Won Cheong

  4. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Je-Hwan Lee

  5. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

    In-Ho Kim

  6. Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Bucheon, South Korea

    Dae Sik Hong

  7. Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, South Korea

    Jae-Sook Ahn & Hyeoung-Joon Kim

  8. Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea

    Won-Sik Lee

  9. Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Chul Won Jung & Jun-Ho Jang

  10. Division of Oncology and Hematology, Department of Internal Medicine, Korea University Medical Center, Seoul, South Korea

    Young Park

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on behalf of the Korean Society of Hematology AML/MDS Working Party

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Correspondence to Hee-Je Kim.

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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.

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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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Shin, HJ., Min, WS., Min, Y.H. et al. Different prognostic effects of core-binding factor positive AML with Korean AML registry data. Ann Hematol 98, 1135–1147 (2019). https://doi.org/10.1007/s00277-019-03624-y

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