Individual patient data-based meta-analysis of patients aged 16 to 60 years with core binding factor acute myeloid leukemia:: A survey of the German Acute Myeloid Leukemia Intergroup
Individual patient data-based meta-analysis of patients aged 16 to 60 years with core binding factor acute myeloid leukemia:: A survey of the German Acute Myeloid Leukemia Intergroup
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DOI：
10.1200/jco.2004.03.012
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发表时间：
2004-09-15
影响因子：
45.3
通讯作者：
Heil, G
中科院分区：
文献类型：
--
作者：
Schlenk, RF;Benner, A;Heil, G
目的评价影响成人核心结合因子(CBF)急性髓系白血病(AML)患者无复发生存期(RFS)和总生存期(OS)的预后因素，以及不同缓解后治疗方法的影响。结果3年后t(8；21)组和inv(16)组RFS分别为60%和58%，OS分别为65%和74%。对于缓解后的治疗，意向治疗分析显示，在t(8；21)组中，强化化疗和自体移植之间没有差异，在inv(16)组中，化疗、自体和异体移植之间没有差异。在t(8；21)组中，较长的RFS和OS的显著预后变量是较低的WBC和较高的血小板计数；男性患者的Y染色体丢失预示较短的OS。在inv(16)组中，22三体是较长RFS的重要预后变量。对于复发的患者，t(8；21)患者的二次完全缓解率显著低于inv(16)患者，导致复发后的生存时间明显低于inv(16)患者。结论我们为CBF AML患者提供了新的预后因素，提示t(8；21)患者复发患者的生存时间较短。(C)2004年，由美国临床肿瘤学会提供。
Purpose To evaluate prognostic factors for relapse-free survival (RFS) and overall survival (OS) and to assess the impact of different postremission therapies in adult patients with core binding factor (CBF) acute myeloid leukemias (AML).Patients and Methods Individual patient data-based meta-analysis was performed on 392 adults (median age, 42 years; range, 16 to 60 years) with CBF AML (t(8;21), n = 191; inv(1 6), n = 201) treated between 1993 and 2002 in prospective German AML treatment trials.Results RFS was 60% and 58% and OS was 65% and 74% in the t(8;21) and inv(16) groups after 3 years, respectively. For postremission therapy, intention-to-treat analysis revealed no difference between intensive chemotherapy and autologous transplantation in the t(8;21) group and between chemotherapy, autologous, and allogeneic transplantation in the inv(16) group. In the t(8;21) group, significant prognostic variables for longer RFS and OS were lower WBC and higher platelet counts; loss of the Y chromosome in male patients was prognostic for shorter OS. In the inv(16) group, trisomy 22 was a significant prognostic variable for longer RFS. For patients who experienced relapse, second complete remission rate was significantly lower in patients with t(8;21), resulting in a significantly inferior survival duration after relapse compared with patients with inv(16).Conclusion We provide novel prognostic factors for CBF AML and show that patients with t(8;21) who experience relapse have an inferior survival duration. (C) 2004 by American Society of Clinical Oncology.