A Chnical Study On The Prognostic Factors Of Acute Myeloid Leukemia With T (8;21), AML1/ETO

Background:AML with t (8;21), AML1/ETO refers to the most common subtypeof adult de novo AML. t(8;21) is one of the most common chromosomaltranslocation patterns, resulting in fusion transcript AMLl/ETO anddestruction of the α subunit of core binding factor (CBF) complex, aswell as the proliferation, differentiation and apoptosis of hematopoieticcells. The prognosis is of these patients relatively good.50-60%can becured with currently available methods. However, some patients rapidlyget deteriorated conditions, despite standardized chemotherapy. AMLwith t(8;21) is believed to have heterogeneity. In clinical practice, it isimportant to analyze and evaluate the accurate prognosis for thesepatients and administer individualized treatment programs, in order toimprove the long-term survival rate and cure rate. Patients may presentwith different molecular pathogenesis, clinical characteristics,chemotherapy response.Objective:To investigate the main risk factors for the survival and prognosis ofadult de novo AML with t (8;21), AML1/ETO in order to improve theaccuracy of the analysis and evaluation of these patient, and provideclinical basis for the administration of individualized treatment programs.Subjects and Methods:60patients with de novo AML with t(8;21), AML1/ETO wereselected from the Cancer Center of the First Affiliated Hospital of Jilin University from January2012to January2015. The subjects’ generalinformation (gender, age, extramedullary infiltration, white blood cellcount, hemoglobin concentration, platelet count at diagnosis), genemutation and consolidation chemotherapy (cytarabine dosage) wererecorded. Kaplan-Meier method was used to screen the factors of overallsurvival and disease-free survival. Further, Cox multivariate regressionmodel was used to complete the multivariate analysis for overall survivaland relapse-free survival.Results:1. Leukocyte count≥20×109/L, extramedullary infiltration atdiagnosis, gene mutations (including FLT3, KIT mutation) are factorsrelated to short survival. Subjects with the loss of sex chromosome, theadministration of high-dose cytarabine for consolidation chemotherapyafter complete remission, achieved a relatively long overall survival(P<0.05). The results of further Cox regression analysis showed theexistence or absence of extramedullary infiltration, C-KIT mutations andthe administration of high-dose cytarabine for consolidationchemotherapy after complete remission, contributed to the difference inoverall survival (P<0.05).2. The results of further Cox regression analysis showed white bloodcell count at diagnosis, and high-dose cytarabine consolidationchemotherapy are independent factors of relapse-free survival. Thedifference was statistically significant (P<0.05).Conclusion:The adult patients with de novo t(8;21)-positive AML are at higherrisk when accompanied with C-KIT gene mutation, while high-dosecytarabine for consolidation chemotherapy after complete remission, isconducive to longer overall survival. White blood cell count at diagnosisand high-dose cytarabine for consolidation therapy are independent factors of disease-free survival.