Yazarlar : Creutzig U, Zimmermann M, Bourquin JP, Dworzak MN, von Neuhoff C, Sander A, Schrauder A, Teigler-Schlegel A, Stary J, Corbacioglu S, Reinhardt D.

Yayın : Blood.

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/21948298

Konu : Lösemi

Literatür İçeriği :  

Abstract

Patients with core binding factor acute myeloid leukemia (CBF-AML) benefit from more intensive chemotherapy, but whether both the t(8;21) or inv(16)/t(16;16) subtypes require intensification remained to be determined. In the two successive studies AML-BFM 98 and -2004, 220 CBF-AML patients were treated using the same chemotherapy backbone, whereby reinduction with high-dose cytarabine and mitoxantrone (HAM) was scheduled for these cohorts only in study -98 but not in -2004 against the background to minimize overtreatment. Five-year overall survival (OS) and event-free survival (EFS) were significantly higher and the cumulative incidence of relapse (CIR) lower in t(8;21) patients treated with HAM (n=78) compared to without HAM (n=53): OS 92%±3% vs. 80%±6%, plogrank0.047, EFS 84%±4% vs. 59%±7%, plogrank0.001, and CIR 14%±4% vs. 34%±7%, p(gray)0.006. These differences were not seen for inv(16) (n=43 and 46, respectively): OS 93%±4% vs. 94%±4%, EFS 75%±7% vs. 71%±9% and CIR 15%±6% vs. 23%±8% (not significant). The subtype t(8;21) but not inv(16) was an independent predictor of worse outcome without HAM reinduction. Based on our data, a five-year OS of more than 90% can be expected for CBF-AML, when stratifying t(8;21) but not inv(16) patients to high risk chemotherapy including HAM reinduction.

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