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Factors associated with risk of central nervous system relapse in patients with non‐core binding factor acute myeloid leukemia
Author(s) -
Jabbour Elias,
Guastad Daver Naval,
Short Nicholas James,
Huang Xuelin,
Chen HsiangChun,
Maiti Abhishek,
Ravandi Farhad,
Cortes Jorge,
Abi Aad Simon,
GarciaManero Guillermo,
Estrov Zeev,
Kadia Tapan,
O'Brien Susan,
Dabaja Bouthaina,
BuesoRamos Carlos,
Strati Paolo,
Bivins Carol,
Pierce Sherry,
Kantarjian Hagop
Publication year - 2017
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.24799
Subject(s) - medicine , myeloid leukemia , cytarabine , oncology , central nervous system , leukemia , chemotherapy , disease , immunology
Central nervous system (CNS) relapse is uncommon in patients with acute myeloid leukemia (AML) with the use of high‐dose cytarabine containing chemotherapy regimens. The clinical and molecular features associated with a higher risk of CNS relapse are not well defined. We assessed the incidence and outcome of CNS relapses among 1245 patients with relapsed/refractory AML referred to our institution between 2000 and 2014. CNS leukemia relapse was observed in 51 patients (4.1%). Using a multivariate regression model and after adjusting for age, FLT3 ‐ITD mutation (OR = 2.33; P = .02) and elevated LDH (>1000 IU/L, OR = 1.99; P = .04) were independent predictive factors for CNS relapse. Patients under 64 years of age with 0, 1, or 2 baseline adverse features had a probability of 3.8%, 7.0%‐8.0%, and 13.9% for developing CNS disease, respectively. Our study identifies patients with AML at higher risk for CNS relapse in whom prophylactic CNS therapy may be warranted.