A multivariate model for predicting induction response and prognosis in core binding factor acute myeloid leukemia

Biao Wang; Xiaoying Hua; Rongrong Lin; Bin Yang; Wei WU; Bai HE; Xiuwen Zhang; Shanshan Xing; Haiqian LI

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A multivariate model for predicting induction response and prognosis in core binding factor acute myeloid leukemia

VernacularTitle: 核心结合因子相关急性髓系白血病的缓解和预后异质性多因素分析
Author: Biao WANG ¹ ; Xiaoying HUA ¹ ; Rongrong LIN ¹ ; Bin YANG ¹ ; Wei WU ¹ ; Bai HE ¹ ; Xiuwen ZHANG ² ; Shanshan XING ³ ; Haiqian LI ¹
Author Information

1. Department of Hematology, Changzhou First People′s Hospital, Changzhou 213000, China
2. Department of Hematology, Nanjing Medical University Affiliated Changzhou Second Hospital, Changzhou 213000, China
3. Department of Hematology, Zhejiang Hospital, Hangzhou 310013, China
Publication Type:Journal Article
Keywords: Core binding factors; Leukemia, myeloid, acute; Prognosis; Antigens, CD₁₉; t(8; 21)
From: Chinese Journal of Internal Medicine 2019;58(11):796-802
CountryChina
Language:Chinese
Abstract: Objective:To evaluate the efficacy and prognostic factors in core binding factor (CBF) acute myeloid leukemia (AML) under current therapy modalities, therefore optimizing the treatment strategies.
Methods:Standard cytological and immune methods including next generation sequencing (NGS) were used for risk stratification. Complete remission (CR) rate, disease-free survival (DFS) and overall survival (OS) were assessed by multivariate Logistic and Cox regression models in a total of 206 adults (aged 16-65 years) with CBF-AML, including 152 AML patients with t(8;21) and 54 with inv(16).
Results:The CR rate of inv(16) patients after first course was 54/54(100%), significantly higher than that of t(8;21) patients [127/147(86.4%), P=0.005]. The fusion transcript level and KIT mutation were independent factors related to CR rate in t(8;21) patients (P=0.044 and 0.027; respectively). DFS and OS in inv(16) patients tended to be more superior than that in t(8;21) patients (P=0.066 for DFS; P=0.306 for OS; respectively). Multivariate Cox identified negative expression of CD₁₉ and female gender the independent predictors of inferior DFS in t(8;21) patients (P=0.000 for CD₁₉; P=0.006 for sex; respectively). Analysis of combining CD₁₉ with gender indicated that females/CD₁^9-subpopulation had significantly poor DFS than did males/CD₁₉⁺ ones (Bonferroni-P<0.000 01). The number of mutations in each patient, FLT3-ITD and additional karyotype abnormalities did not affect CR rate and DFS (all P>0.05).
Conclusions:Patients with inv(16) have better induction response than those with t(8;21). High level of fusion transcripts and positive KIT mutation are associated with low CR rate in t(8;21) patients. Negative CD₁₉ expression and female gender are independent predictors of inferior DFS in t(8;21) patients.