Hematopoietic stem cell transplantation for core binding factor acute myeloid leukemia: t(8;21) and inv(16) represent different clinical outcomes

• Published in: Blood Vol. 113; no. 9; pp. 2096 - 2103
• Main Authors: Kuwatsuka, Yachiyo, Miyamura, Koichi, Suzuki, Ritsuro, Kasai, Masaharu, Maruta, Atsuo, Ogawa, Hiroyasu, Tanosaki, Ryuji, Takahashi, Satoshi, Koda, Kyuhei, Yago, Kazuhiro, Atsuta, Yoshiko, Yoshida, Takashi, Sakamaki, Hisashi, Kodera, Yoshihisa
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 26-02-2009; Americain Society of Hematology
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Chromosome Inversion; Chromosomes, Human, Pair 16; Chromosomes, Human, Pair 21; Chromosomes, Human, Pair 8; Core Binding Factors - genetics; Female; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Prognosis; Survival Analysis; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Translocation, Genetic; Treatment Outcome; Young Adult; Chromosomal aberration; Human; Acute myelogenous leukemia; Prognosis; Transcription factor CBF; Stem cell; Hematopoietic cell; Malignant hemopathy; Myeloproliferative syndrome; Abnormal chromosome C8; Treatment; Abnormal chromosome E16; Cytogenetics; Abnormal chromosome; Abnormal chromosome G21; Graft; Cancer; Chromosome inversion; Chromosome translocation
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2008-03-145862

We analyzed 338 adult patients with acute myeloid leukemia (AML) with t(8;21) and inv(16) undergoing stem cell transplantation (SCT) who were registered in the Japan Society for Hematopoietic Cell Transplantation database. At 3 years, overall survival (OS) of patients with t(8;21) and inv(16) was 50% and 72%, respectively (P = .002). Although no difference was observed when restricted to allogeneic SCT in first complete remission (CR; 84% and 74%), OS of patients with t(8;21) and inv(16) undergoing allogeneic SCT in second or third CR (45% and 86% at 3 years; P = .008) was different. OS was not different between patients in first CR who received allogeneic SCT and those who received autologous SCT for both t(8;21) AML (84% vs 77%; P = .49) and inv(16) AML (74% vs 59%; P = .86). Patients with inv(16) not in CR did better after allogeneic SCT than those with t(8;21) (70% and 18%; P = .03). Patients with t(8;21) and inv(16) should be managed differently as to the application of SCT. SCT in first CR is not necessarily recommended for inv(16). For t(8;21) patients in first CR, a prospective trial is needed to clarify the significance of autologous SCT and allogeneic SCT over chemotherapy.