1. Non-age-related neoplastic loss of sex chromosome correlated with prolonged survival in real-world CBF-AML patients
- Author
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Toru Miyajima, Yutaka Tsutsumi, Akio Mori, Satoshi Yamamoto, Shinichi Fujisawa, Takanori Teshima, Takahiro Nagashima, Yasutaka Kakinoki, Shuichi Ota, Yoshihito Haseyama, Hajime Kobayashi, Takuto Miyagishima, Hiroshi Iwasaki, Daisuke Hidaka, Mitsutoshi Kurosawa, Reiki Ogasawara, Emi Yokoyama, Takeshi Kondo, Koh Izumiyama, Masanobu Morioka, Shota Yokoyama, Masahiro Onozawa, and Makoto Saito
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Oncogene Proteins, Fusion ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,Gastroenterology ,Core Binding Factor beta Subunit ,chemistry.chemical_compound ,Young Adult ,Internal medicine ,medicine ,Humans ,Metaphase ,Sex Chromosome Aberrations ,Aged ,Hematology ,Sex Chromosomes ,business.industry ,Myeloid leukemia ,Chromosome ,Karyotype ,Middle Aged ,Minimal residual disease ,Survival Analysis ,Leukemia, Myeloid, Acute ,RUNX1 ,chemistry ,Female ,business - Abstract
In this real-world clinical study, in which we determined eligibility for allogenic hematopoietic stem cell transplantation by prognostic factors and minimal residual disease status, we retrospectively evaluated cytogenetic, genetic, and clinical features in 96 patients with core-binding factor acute myeloid leukemia (CBF-AML) including 62 patients with RUNX1/RUNX1T1 and 34 patients with CBFβ/MYH11. Multivariate analyses for 5-year overall survival (OS) in CBF-AML patients revealed that age of 50 years or older (HR: 3.46, 95% CI 1.47-8.11, P = 0.004) and receiving 2 or more induction cycles (HR: 3.55, 95% CI 1.57-8.05, P = 0.002) were independently associated with worse OS and that loss of sex chromosome (LOS) was independently associated with better OS (HR: 0.09, 95% CI 0.01-0.71, P = 0.022). At the time of complete remission, all 21 karyotyped patients with LOS had a normal karyotype. Furthermore, in all 9 patients with LOS who had a mosaic of metaphase cells with and without t(8;21) or inv(16), the metaphase cells without t(8;21)/inv(16) showed a normal karyotype. These results proved that LOS was not age-related and physiological, but rather a neoplastic chromosomal abnormality.
- Published
- 2021