Secondary cytogenetic abnormalities in core-binding factor AML harboring inv(16) vs t(8;21)

Se Young Han, Krzysztof Mrozek, Jenna Voutsinas, Qian Wu, Elizabeth A. Morgan, Hanne Vestergaard, Robert Ohgami, Philip M. Kluin, Thomas Kielsgaard Kristensen, Sheeja Pullarkat, Michael Boe Moller, Ana-Iris Schiefer, Linda B. Baughn, Young Kim, David Czuchlewski, Jacobien R. Hilberink, Hans-Peter Horny, Tracy George, Michelle Dolan, Nam K. KuCecilia Arana Yi, Vinod Pullarkat, Jessica Kohlschmidt, Amandeep Salhotra, Lori Soma, Clara D. Bloomfield, Dong Chen, Wolfgang R. Sperr, Guido Marcucci, Christina Cho, Cem Akin, Jason Gotlib, Sigurd Broesby-Olsen, Melissa Larson, Michael A. Linden, H. Joachim Deeg, Gregor Hoermann, Miguel-Angel Perales, Jason L. Hornick, Mark R. Litzow, Ryotaro Nakamura, Daniel Weisdorf, Gautam Borthakur, Gerwin Huls, Peter Valent, Celalettin Ustun, Cecilia C. S. Yeung*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Patients with core-binding factor (CBF) acute myeloid leukemia (AML), caused by either t(8; 21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22), have higher complete remission rates and longer survival than patients with other subtypes of AML. However, similar to 40% of patients relapse, and the literature suggests that patients with inv(16) fare differently from those with t(8;21). We retrospectively analyzed 537 patients with CBF-AML, focusing on additional cytogenetic aberrations to examine their impact on clinical outcomes. Trisomies of chromosomes 8, 21, or 22 were significantly more common in patients with inv(16)/t(16;16): 16% vs 7%, 6% vs 0%, and 17% vs 0%, respectively. In contrast, del(9q) and loss of a sex chromosome were more frequent in patients with t(8;21): 15% vs 0.4% for del(9q), 37% vs 0% for loss of X in females, and 44% vs 5% for loss of Y in males. Hyperdiploidy was more frequent in patients with inv(16) (25% vs 9%, whereas hypodiploidy was more frequent in patients with t(8;21) (37% vs 3%. In multivariable analyses (adjusted for age, white blood counts at diagnosis, and KIT mutation status), trisomy 8 was associated with improved overall survival (OS) in inv(16), whereas the presence of other chromosomal abnormalities (not trisomy 8) was associated with decreased OS. In patients with t(8;21), hypodiploidy was associated with improved disease-free survival; hyperdiploidy and del(9q) were associated with improved OS. KIT mutation (either positive or not tested, compared with negative) conferred poor prognoses in univariate analysis only in patients with t(8;21).

Original languageEnglish
Pages (from-to)2481-2489
Number of pages9
JournalBlood
Volume5
Issue number10
Early online date18-May-2021
DOIs
Publication statusPublished - 25-May-2021

Keywords

  • ACUTE MYELOID-LEUKEMIA
  • MINIMAL RESIDUAL DISEASE
  • C-KIT MUTATIONS
  • PROGNOSTIC IMPACT
  • GENE
  • SURVIVAL
  • EXPRESSION
  • RELAPSE
  • CANCER

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