Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities

Abstract High‐dose cytarabine (Ara‐C) has been reported with increased treatment‐related mortality, whereas few data are available concerning intermediate‐dose Ara‐C for induction of acute myeloid leukemia (AML) with t(8;21) translocation. We retrospectively analyzed factors impacting complete remis...

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Main Authors: Biao Wang, Bin Yang, Yun Ling, Jihong Zhang, Xiaoying Hua, Weiying Gu, Feng Yan
Format: Article
Language:English
Published: Wiley 2021-02-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.3705
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author Biao Wang
Bin Yang
Yun Ling
Jihong Zhang
Xiaoying Hua
Weiying Gu
Feng Yan
author_facet Biao Wang
Bin Yang
Yun Ling
Jihong Zhang
Xiaoying Hua
Weiying Gu
Feng Yan
author_sort Biao Wang
collection DOAJ
description Abstract High‐dose cytarabine (Ara‐C) has been reported with increased treatment‐related mortality, whereas few data are available concerning intermediate‐dose Ara‐C for induction of acute myeloid leukemia (AML) with t(8;21) translocation. We retrospectively analyzed factors impacting complete remission (CR), event‐free survival (EFS), cumulative incidence of relapse (CIR), and overall survival (OS) in 197 adults with t(8;21) AML, of whom 107 cases were induced with intermediate‐dose and 90 with standard‐dose Ara‐C (as part of 3 + 7 protocol). After a single induction course, the overall CR rate was 87.6% (170/194), with a significant difference between the standard‐dose (83/105, 79.0%) and intermediate‐dose (87/89, 97.8%) groups (p < 0.001). Rather than general KITmut, the specific KIT‐D816 independently led to a lower probability of achieving CR (HR = 3.29 [1.18–9.24], p = 0.023), worse EFS (HR = 3.53 [1.82–6.84], p < 0.001), and OS (HR = 5.45 [1.77–16.84], p = 0.003) in the standard‐dose group, but not in the intermediate‐dose group. CD19(+) represented the only independent factor predicting lower CIR both in the standard‐dose group (HR = 0.32 [0.10–1.00], p = 0.050) and in the intermediate‐dose group (HR = 0.11 [0.03–0.40], p = 0.001). When combined, KIT(+) plus CD19(−) conferred the most increased relapse risk (3‐year CIR 60%; SE 0.12). Specific KIT‐D816, instead of general KITmut, may be incorporated in prognostication model for t(8;21) AML. Combination of CD19 with KIT provides a more definite risk stratification profile for t(8;21) AML.
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spelling doaj.art-1c6edc2070e84e1d933f041c311f08842022-12-21T22:28:04ZengWileyCancer Medicine2045-76342021-02-011031091110210.1002/cam4.3705Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensitiesBiao Wang0Bin Yang1Yun Ling2Jihong Zhang3Xiaoying Hua4Weiying Gu5Feng Yan6Department of Hematology Changzhou First People's Hospital Changzhou ChinaDepartment of Hematology Changzhou First People's Hospital Changzhou ChinaDepartment of Hematology Changzhou First People's Hospital Changzhou ChinaBlood Research Laboratory Shengjing Hospital of China Medical University Shenyang ChinaDepartment of Hematology Changzhou First People's Hospital Changzhou ChinaDepartment of Hematology Changzhou First People's Hospital Changzhou ChinaDepartment of Hematology Changzhou First People's Hospital Changzhou ChinaAbstract High‐dose cytarabine (Ara‐C) has been reported with increased treatment‐related mortality, whereas few data are available concerning intermediate‐dose Ara‐C for induction of acute myeloid leukemia (AML) with t(8;21) translocation. We retrospectively analyzed factors impacting complete remission (CR), event‐free survival (EFS), cumulative incidence of relapse (CIR), and overall survival (OS) in 197 adults with t(8;21) AML, of whom 107 cases were induced with intermediate‐dose and 90 with standard‐dose Ara‐C (as part of 3 + 7 protocol). After a single induction course, the overall CR rate was 87.6% (170/194), with a significant difference between the standard‐dose (83/105, 79.0%) and intermediate‐dose (87/89, 97.8%) groups (p < 0.001). Rather than general KITmut, the specific KIT‐D816 independently led to a lower probability of achieving CR (HR = 3.29 [1.18–9.24], p = 0.023), worse EFS (HR = 3.53 [1.82–6.84], p < 0.001), and OS (HR = 5.45 [1.77–16.84], p = 0.003) in the standard‐dose group, but not in the intermediate‐dose group. CD19(+) represented the only independent factor predicting lower CIR both in the standard‐dose group (HR = 0.32 [0.10–1.00], p = 0.050) and in the intermediate‐dose group (HR = 0.11 [0.03–0.40], p = 0.001). When combined, KIT(+) plus CD19(−) conferred the most increased relapse risk (3‐year CIR 60%; SE 0.12). Specific KIT‐D816, instead of general KITmut, may be incorporated in prognostication model for t(8;21) AML. Combination of CD19 with KIT provides a more definite risk stratification profile for t(8;21) AML.https://doi.org/10.1002/cam4.3705acute myeloid leukemiaCD19cytarabineKITt(8;21)
spellingShingle Biao Wang
Bin Yang
Yun Ling
Jihong Zhang
Xiaoying Hua
Weiying Gu
Feng Yan
Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
Cancer Medicine
acute myeloid leukemia
CD19
cytarabine
KIT
t(8;21)
title Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
title_full Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
title_fullStr Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
title_full_unstemmed Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
title_short Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
title_sort role of cd19 and specific kit d816 on risk stratification refinement in t 8 21 acute myeloid leukemia induced with different cytarabine intensities
topic acute myeloid leukemia
CD19
cytarabine
KIT
t(8;21)
url https://doi.org/10.1002/cam4.3705
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