Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia

Sung Soo Park; Jae Ho Yoon; Hee Je Kim; Young Woo Jeon; Sung Eun Lee; Byung Sik Cho; Ki Seong Eom; Yoo Jin Kim; Seok Lee; Chang Ki Min; Seok Goo Cho; Dong Wook Kim; Jong Wook Lee; Woo Sung Min

doi:10.1016/j.clml.2016.09.001

Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia

Sung Soo Park, Jae Ho Yoon, Hee Je Kim, Young Woo Jeon, Sung Eun Lee, Byung Sik Cho, Ki Seong Eom, Yoo Jin Kim, Seok Lee, Chang Ki Min, Seok Goo Cho, Dong Wook Kim, Jong Wook Lee, Woo Sung Min

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Extramedullary (EM) involvement in acute myeloid leukemia with t(8;21) is not a rare manifestation. EM involvement has been regarded as a poor prognostic factor although t(8;21) is a favorable-risk karyotype. We analyzed 154 patients and identified EM involvement was associated with young age, leukocytosis, and c-kit mutation. Outcomes were similar after transplantation-based treatment strategy regardless of EM involvement. Background Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. Patients and Methods We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis. EM involvement was evaluated only when a patient showed suspicious signs or symptoms. All EM-positive patients were treated according to a strategy based on allogeneic hematopoietic cell transplantation (allo-HCT). Results Central nervous system was the most frequently involved site (70.6%). EM-positive t(8;21) was associated with age ≤ 45 years, leukocytosis (≥ 30 × 10⁹/L), and c-kit mutation compared to EM-negative t(8;21) in multivariate analysis. After intensive chemotherapy with or without local therapy, high-risk t(8;21) AML including EM-positive t(8;21) underwent allo-HCT for postremission therapy. Three-year OS (52.3% vs. 60.0%, P = .658) and event-free survival (51.5% vs. 58.0%, P = .496) were not different between the 2 groups. The subgroup of patients who underwent allo-HCT also showed similar outcomes. Conclusion EM-positive t(8;21) was associated with young age, leukocytosis, and c-kit mutation, and central nervous system was frequently involved. Allo-HCT resulted in good outcomes in EM-positive t(8;21).

Original language	English
Pages (from-to)	38-45.e2
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	17
Issue number	1
DOIs	https://doi.org/10.1016/j.clml.2016.09.001
State	Published - 1 Jan 2017

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Inc.

Keywords

c-kit
Central nervous system
Core-binding factor
Extramedullary
Hematopoietic cell transplantation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.clml.2016.09.001

Cite this

Park, S. S., Yoon, J. H., Kim, H. J., Jeon, Y. W., Lee, S. E., Cho, B. S., Eom, K. S., Kim, Y. J., Lee, S., Min, C. K., Cho, S. G., Kim, D. W., Lee, J. W., & Min, W. S. (2017). Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia. Clinical Lymphoma, Myeloma and Leukemia, 17(1), 38-45.e2. https://doi.org/10.1016/j.clml.2016.09.001

@article{608fd112b719484c84e50eea926d2554,

title = "Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia",

abstract = "Extramedullary (EM) involvement in acute myeloid leukemia with t(8;21) is not a rare manifestation. EM involvement has been regarded as a poor prognostic factor although t(8;21) is a favorable-risk karyotype. We analyzed 154 patients and identified EM involvement was associated with young age, leukocytosis, and c-kit mutation. Outcomes were similar after transplantation-based treatment strategy regardless of EM involvement. Background Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. Patients and Methods We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis. EM involvement was evaluated only when a patient showed suspicious signs or symptoms. All EM-positive patients were treated according to a strategy based on allogeneic hematopoietic cell transplantation (allo-HCT). Results Central nervous system was the most frequently involved site (70.6\%). EM-positive t(8;21) was associated with age ≤ 45 years, leukocytosis (≥ 30 × 109/L), and c-kit mutation compared to EM-negative t(8;21) in multivariate analysis. After intensive chemotherapy with or without local therapy, high-risk t(8;21) AML including EM-positive t(8;21) underwent allo-HCT for postremission therapy. Three-year OS (52.3\% vs. 60.0\%, P = .658) and event-free survival (51.5\% vs. 58.0\%, P = .496) were not different between the 2 groups. The subgroup of patients who underwent allo-HCT also showed similar outcomes. Conclusion EM-positive t(8;21) was associated with young age, leukocytosis, and c-kit mutation, and central nervous system was frequently involved. Allo-HCT resulted in good outcomes in EM-positive t(8;21).",

keywords = "c-kit, Central nervous system, Core-binding factor, Extramedullary, Hematopoietic cell transplantation",

author = "Park, \{Sung Soo\} and Yoon, \{Jae Ho\} and Kim, \{Hee Je\} and Jeon, \{Young Woo\} and Lee, \{Sung Eun\} and Cho, \{Byung Sik\} and Eom, \{Ki Seong\} and Kim, \{Yoo Jin\} and Seok Lee and Min, \{Chang Ki\} and Cho, \{Seok Goo\} and Kim, \{Dong Wook\} and Lee, \{Jong Wook\} and Min, \{Woo Sung\}",

note = "Publisher Copyright: {\textcopyright} 2016 Elsevier Inc.",

year = "2017",

month = jan,

day = "1",

doi = "10.1016/j.clml.2016.09.001",

language = "English",

volume = "17",

pages = "38--45.e2",

journal = "Clinical Lymphoma, Myeloma and Leukemia",

issn = "2152-2650",

publisher = "Elsevier Inc.",

number = "1",

}

Park, SS, Yoon, JH, Kim, HJ, Jeon, YW, Lee, SE, Cho, BS, Eom, KS, Kim, YJ, Lee, S, Min, CK, Cho, SG, Kim, DW, Lee, JW & Min, WS 2017, 'Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia', Clinical Lymphoma, Myeloma and Leukemia, vol. 17, no. 1, pp. 38-45.e2. https://doi.org/10.1016/j.clml.2016.09.001

TY - JOUR

T1 - Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia

AU - Park, Sung Soo

AU - Yoon, Jae Ho

AU - Kim, Hee Je

AU - Jeon, Young Woo

AU - Lee, Sung Eun

AU - Cho, Byung Sik

AU - Eom, Ki Seong

AU - Kim, Yoo Jin

AU - Lee, Seok

AU - Min, Chang Ki

AU - Cho, Seok Goo

AU - Kim, Dong Wook

AU - Lee, Jong Wook

AU - Min, Woo Sung

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Extramedullary (EM) involvement in acute myeloid leukemia with t(8;21) is not a rare manifestation. EM involvement has been regarded as a poor prognostic factor although t(8;21) is a favorable-risk karyotype. We analyzed 154 patients and identified EM involvement was associated with young age, leukocytosis, and c-kit mutation. Outcomes were similar after transplantation-based treatment strategy regardless of EM involvement. Background Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. Patients and Methods We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis. EM involvement was evaluated only when a patient showed suspicious signs or symptoms. All EM-positive patients were treated according to a strategy based on allogeneic hematopoietic cell transplantation (allo-HCT). Results Central nervous system was the most frequently involved site (70.6%). EM-positive t(8;21) was associated with age ≤ 45 years, leukocytosis (≥ 30 × 109/L), and c-kit mutation compared to EM-negative t(8;21) in multivariate analysis. After intensive chemotherapy with or without local therapy, high-risk t(8;21) AML including EM-positive t(8;21) underwent allo-HCT for postremission therapy. Three-year OS (52.3% vs. 60.0%, P = .658) and event-free survival (51.5% vs. 58.0%, P = .496) were not different between the 2 groups. The subgroup of patients who underwent allo-HCT also showed similar outcomes. Conclusion EM-positive t(8;21) was associated with young age, leukocytosis, and c-kit mutation, and central nervous system was frequently involved. Allo-HCT resulted in good outcomes in EM-positive t(8;21).

AB - Extramedullary (EM) involvement in acute myeloid leukemia with t(8;21) is not a rare manifestation. EM involvement has been regarded as a poor prognostic factor although t(8;21) is a favorable-risk karyotype. We analyzed 154 patients and identified EM involvement was associated with young age, leukocytosis, and c-kit mutation. Outcomes were similar after transplantation-based treatment strategy regardless of EM involvement. Background Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. Patients and Methods We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis. EM involvement was evaluated only when a patient showed suspicious signs or symptoms. All EM-positive patients were treated according to a strategy based on allogeneic hematopoietic cell transplantation (allo-HCT). Results Central nervous system was the most frequently involved site (70.6%). EM-positive t(8;21) was associated with age ≤ 45 years, leukocytosis (≥ 30 × 109/L), and c-kit mutation compared to EM-negative t(8;21) in multivariate analysis. After intensive chemotherapy with or without local therapy, high-risk t(8;21) AML including EM-positive t(8;21) underwent allo-HCT for postremission therapy. Three-year OS (52.3% vs. 60.0%, P = .658) and event-free survival (51.5% vs. 58.0%, P = .496) were not different between the 2 groups. The subgroup of patients who underwent allo-HCT also showed similar outcomes. Conclusion EM-positive t(8;21) was associated with young age, leukocytosis, and c-kit mutation, and central nervous system was frequently involved. Allo-HCT resulted in good outcomes in EM-positive t(8;21).

KW - c-kit

KW - Central nervous system

KW - Core-binding factor

KW - Extramedullary

KW - Hematopoietic cell transplantation

UR - https://www.scopus.com/pages/publications/85002158073

U2 - 10.1016/j.clml.2016.09.001

DO - 10.1016/j.clml.2016.09.001

M3 - Article

C2 - 27742476

AN - SCOPUS:85002158073

SN - 2152-2650

VL - 17

SP - 38-45.e2

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

IS - 1

ER -

Characteristics and Survival Outcome Analysis of Extramedullary Involvement in Adult Patients With t(8;21) Acute Myeloid Leukemia

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this