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Role of CD19 and specific KIT‐D816 on risk stratification refinement in t(8;21) acute myeloid leukemia induced with different cytarabine intensities
Author(s) -
Wang Biao,
Yang Bin,
Ling Yun,
Zhang Jihong,
Hua Xiaoying,
Gu Weiying,
Yan Feng
Publication year - 2021
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3705
Subject(s) - cytarabine , myeloid leukemia , cumulative incidence , medicine , gastroenterology , myeloid , cumulative dose , incidence (geometry) , cohort , physics , optics
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 KIT mut, 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 KIT mut, 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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