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MRD-directed risk stratification treatment may improve outcomes of t(8;21) AML in the first complete remission: results from the AML05 multicenter trial

Hong-Hu Zhu, Xiao-Hui Zhang, Ya-Zhen Qin, Dai-Hong Liu, Hao Jiang, Huan Chen, Qian Jiang, Lan-Ping Xu, Jin Lu, Wei Han, Li Bao, Yu Wang, Yu-Hong Chen, Jing-Zhi Wang, Feng-Rong Wang, Yue-Yun Lai, Jun-Yue Chai, Li-Ru Wang, Yan-Rong Liu, Kai-Yan Liu, Bin Jiang and Xiao-Jun Huang

Data supplements

Article Figures & Data

Figures

  • Figure 1

    AML05 treatment scheme. Con, consolidation; Ind, induction.

  • Figure 2

    Trial design and patient accrual flowchart. Eighty-two and 34 patients achieved CR after 1 and 2 induction cycles. Sixty-three of 116 patients received anthracycline during consolidation cycles 1 and 2, including 45 mg/m2 daunorubicin or 8 mg/m2 mitoxantrone for 3 days. CT, chemotherapy.

  • Figure 3

    Subgroup analysis of risk stratification treatments and outcomes of t(8;21) AML. (A,D) Relapse. (B,E) DFS. (C,F) OS. HSCT, hematopoietic stem cell transplantation; CT, chemotherapy.

  • Figure 4

    Outcome by KIT gene mutations and treatments of t (8;21) AML patients. The comparison of (A,D) relapse, (B,E) DFS, and (C,F) OS between patients receiving hematopoietic stem cell transplantation (HSCT) and chemotherapy (CT).

Tables

  • Table 1

    Characteristics of t(8;21) AML

    CharacteristicRisk directedNot risk directed
    Low risk—chemo (n = 29)High risk—HSCT (n = 40)TotalLow risk—HSCT (n = 18)High risk—Chemo (n = 29)TotalP
    Age (years)28 (15-56)37 (15-54)33 (15-56)35 (16-54)37 (15-60)36 (15-60)NS
    Gender (male/female)16/1626/1439/3012/616/1328/19NS
    WBC (109/L)5.4 (1.4-79)9.0 (1.9-59)8.1 (1.4-79)6.0 (1.2-30)8.0 (2.5-80.5)7.2 (1.2-80.5)NS
    HGB (g/L)83 (34-136)81 (49-133)81(45-136)95 (41-123)74 (34-135)78 (34-135)NS
    PLT (109/L)37 (5-286)27 (4-108)32.5 (4-286)33 (2-106)35 (7-225)34 (2-225)NS
    Blasts in BM (%)52 (26-89)51 (20-86)52(20-89)56 (21-82)39 (24-92)46 (21-92)NS
    RUNX1-RUNX1T1 (%)506 (353-993)411(97-1082)439 (35-1082)422 (98-848)358(52-1163)380 (43-1163)NS
    KIT mutation (%)17.6(3/17)54.8(17/31)54.8(20/48)50(5/10)34.6(9/26)38.9(14/36)NS
    Comorbidity score (0/1-2/3)*23/17/018/11/041/28/016/13/011/7/027/20/0NS
    • There are no differences in the characteristics between the low riskchemotherapy group and the low riskHSCT group and between the high riskchemotherapy group and the high riskHSCT group. HGB, hemoglobin; PLT, platelet; BM, bone marrow; NS, not significant.

    • * According to the Charlson Comorbidity Index.

  • Table 2

    Multivariable analysis of prognostic factors

    CovariateCIR PDFS POS P
    MRD (high vs low risk).0030.0020.020
    Treatment (risk directed vs not risk directed).026.036.037
    KIT (mutation vs wild type).049NSNS
    BM blasts (≥50% vs <50%)NSNSNS
    WBC (≥20 vs <20)NSNSNS
    CD56 (positive vs negative)NSNSNS
    Age (<35 vs ≥35 years old)NSNSNS
    CR (1 vs >1 course)NSNSNS
    Cytogenetic (with vs without additional changes)NSNSNS
    • BM, bone marrow.