Prognostic markers in core‐binding factor AML AML and improved survival with multiple consolidation cycles of intermediate‐/high‐dose cytarabine

摘要

Abstract Objectives Core‐binding factor acute myeloid leukaemia ( CBF AML ) defined by t (8;21)(q22;q22) or inv(16)(p13q22)/ t (16;16)(p13;q22) has a favourable prognosis; however, 30%‐40% of patients still relapse after chemotherapy. We sought to evaluate the risk factors for relapse in a de novo CBF AML cohort. Patients/Materials/Methods A retrospective review of patients from four Australian tertiary centres from 2001 to 2012, comprising 40 t (8;21) and 30 inv(16) AML s. Results Multivariate analysis identified age ( P ?=?.032) and white cell count ( WCC )40 ( P ?=?.025) as significant predictors for inferior OS and relapse, respectively. Relapse risk was higher in the inv(16) group vs the t (8;21) group (57% vs 18%, HR 4.31, 95% CI : 1.78‐10.42, P ?=?.001). Induction therapy had no bearing on OS or relapse‐free survival ( RFS ); however, consolidation treatment with 3 cycles of intermediate‐/high‐dose cytarabine improved OS ( P ?=?.035) and RFS ( P ?=?.063). Five patients demonstrated post‐treatment stable q PCR positivity without relapse. Conclusions 3 consolidation cycles of intermediate‐/high‐dose cytarabine improves patient outcomes Age and inv(16) CBF AML subtype are predictors of inferior OS and RFS , respectively. Stable low‐level MRD by qPCR does not predict relapse Similar OS in the inv(16) cohort compared to the t (8;21) cohort, despite a higher relapse rate, confirms salvageability of relapsed disease.