CLINICAL FEATURES AND OUTCOME OF PATIENTS WITH CORE BINDING FACTOR ACUTE MYELOID LEUKEMIA
(Abstract release date: 05/18/17)
EHA Library. Taoussi S. 05/18/17; 182404; PB1690
Souad Taoussi
Contributions
Contributions
Abstract
Abstract: PB1690
Type: Publication Only
Background
Acute Myeloid leukemia is classified into different prognostic groups according to their cytogenetic profil; AML with t (8; 21) or inv16/ t (16; 16) called AML CBF belong to a prognostic group of low-risk; they represent 15% to 20% of the AML.
Aims
The aim of this study is to present clinical, cytogentic features and outcome of this group of patients (pts) in an emerging country.
Methods
Cytologic diagnosis of AML CBF is completed by immunophenotyping and cytogenetic analysis:
t(8; 21), inversion 16/t (16.16) and del 16q22.
Induction treatment: Daunorubicin 45 to 90 mg/m² day (d1-d3) + Cytarabine 100 mg/m² (d1- d7) (with progressive doses if major leukocytosis). Assessment between d 21 and d 28 by bone marrow analysis ; If failure a second course induction is performed by Cytarabine high dose 3 g m²/12 h d1, d3, d5. Central nervous system prophylaxis for patients (pts) with AML4, M5 and hyperleukocytosis forms. Consolidation: Cytarabine high dose: 2 to 3 cures; low dose of chemotherapy for pts older than 55 years or pts presented severe toxicity at the first induction. Research of Kit, FLT3 and residual disease is not available in our laboratory, hematological stem cell transplantation (HSCT) was proposed for all pts; if no compatible donor, 3 courses of Cytarabine high doses was instituted.
Results
From 2010 to 2016, cytogenetic analysis was performed in all cases of AML of which 58 cases (18,6%) of LAM - CBF were diagnosed. The male to female ratio was 0.5 ; average age: 37 years (16-72); t (8,21) was found in 28 pts (16 M,12F); inversion (16)(p13.11;q22.1), t(16,16)(p13.11;q22.1) and del 16q22 were found in 30 pts (12M,18F), respectively in 27 pts, 2 pts and 1 pt. Four cases of del(16)(p13) were associated with inv(16). For inv(16), FAB subtypes were AML4 (26), AML2 (1) and 3 AML; For t(8;21), there was 26 AML2 and 2 AML4.
Evaluation of induction: not evaluable: 13 cases, Complete Remission (CR): 38 cases (65,5%); for 7 cases in failure, a second induction was proposed, we obtained 2 CR. 15 pts were transplanted. Outcome: 27 pts are alive in CR of which 12 transplanted . 31 pts died of which 18 toxic deaths ( 15 after induction treatment and 3 after engraftment). Median overal survival for inv(16) : 11 months vs 15 months for t(8;21) (p=0,87).
Conclusion
In our study, the frequency of the CBF AML is closer than those described in another Algerian study and literature: 18,6% vs. 15.4% and 20% respectively; a slight predominance of the inv 16 or t (16; 16) identical to that reported by the SWOG study. The RC rate is under to that reported by the CALGB study. We noted less relapse compared with literature. Relapses were observed in pts with poor prognostic factors: age, leukocytosis and failure to first induction. Regarding the favorable prognosis of AML CBF, our results are bad because the high rate of toxic deaths.
The CBF AML are characterized by a better prognosis, but with a 30% relapse rate essentially when associate poor prognosis factors such as a kit mutation that increases the risk to 70%, mutation FLT3, advanced age, the leukocytosis, severe thrombocytopenia and additional cytogenetic abnormalities.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Cytogenetics, Core binding factor leukemia, Acute Myeloid Leukemia
Abstract: PB1690
Type: Publication Only
Background
Acute Myeloid leukemia is classified into different prognostic groups according to their cytogenetic profil; AML with t (8; 21) or inv16/ t (16; 16) called AML CBF belong to a prognostic group of low-risk; they represent 15% to 20% of the AML.
Aims
The aim of this study is to present clinical, cytogentic features and outcome of this group of patients (pts) in an emerging country.
Methods
Cytologic diagnosis of AML CBF is completed by immunophenotyping and cytogenetic analysis:
t(8; 21), inversion 16/t (16.16) and del 16q22.
Induction treatment: Daunorubicin 45 to 90 mg/m² day (d1-d3) + Cytarabine 100 mg/m² (d1- d7) (with progressive doses if major leukocytosis). Assessment between d 21 and d 28 by bone marrow analysis ; If failure a second course induction is performed by Cytarabine high dose 3 g m²/12 h d1, d3, d5. Central nervous system prophylaxis for patients (pts) with AML4, M5 and hyperleukocytosis forms. Consolidation: Cytarabine high dose: 2 to 3 cures; low dose of chemotherapy for pts older than 55 years or pts presented severe toxicity at the first induction. Research of Kit, FLT3 and residual disease is not available in our laboratory, hematological stem cell transplantation (HSCT) was proposed for all pts; if no compatible donor, 3 courses of Cytarabine high doses was instituted.
Results
From 2010 to 2016, cytogenetic analysis was performed in all cases of AML of which 58 cases (18,6%) of LAM - CBF were diagnosed. The male to female ratio was 0.5 ; average age: 37 years (16-72); t (8,21) was found in 28 pts (16 M,12F); inversion (16)(p13.11;q22.1), t(16,16)(p13.11;q22.1) and del 16q22 were found in 30 pts (12M,18F), respectively in 27 pts, 2 pts and 1 pt. Four cases of del(16)(p13) were associated with inv(16). For inv(16), FAB subtypes were AML4 (26), AML2 (1) and 3 AML; For t(8;21), there was 26 AML2 and 2 AML4.
Evaluation of induction: not evaluable: 13 cases, Complete Remission (CR): 38 cases (65,5%); for 7 cases in failure, a second induction was proposed, we obtained 2 CR. 15 pts were transplanted. Outcome: 27 pts are alive in CR of which 12 transplanted . 31 pts died of which 18 toxic deaths ( 15 after induction treatment and 3 after engraftment). Median overal survival for inv(16) : 11 months vs 15 months for t(8;21) (p=0,87).
Conclusion
In our study, the frequency of the CBF AML is closer than those described in another Algerian study and literature: 18,6% vs. 15.4% and 20% respectively; a slight predominance of the inv 16 or t (16; 16) identical to that reported by the SWOG study. The RC rate is under to that reported by the CALGB study. We noted less relapse compared with literature. Relapses were observed in pts with poor prognostic factors: age, leukocytosis and failure to first induction. Regarding the favorable prognosis of AML CBF, our results are bad because the high rate of toxic deaths.
The CBF AML are characterized by a better prognosis, but with a 30% relapse rate essentially when associate poor prognosis factors such as a kit mutation that increases the risk to 70%, mutation FLT3, advanced age, the leukocytosis, severe thrombocytopenia and additional cytogenetic abnormalities.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Cytogenetics, Core binding factor leukemia, Acute Myeloid Leukemia
{{ help_message }}
{{filter}}