Prognostic Factors in Acute Myeloid Leukemia with t(8;21)/AML1-ETO: Strategies to Define High-Risk Patients.

Acute myeloid leukemia (AML) with t(8;21)/AML1-ETO is considered to have favorable prognosis. However, outcome is not universally satisfactory. The aim of this study was to search for potential prognostic risk factors which can help individualized treatment in t(8;21) AML patients. All available clinical and laboratory indicators were analyzed retrospectively in 103 t (8;21) AML patients. All patients were followed up for median of 30 months (range 0.3-73 months). CD56 and IDH1 were found to be closely related to high recurrence (p = 0.002; p = 0.001) and incidence of cumulative recurrence (p = 0.001; p < 0.0001). C-KIT was associated with a high cumulative incidence of non-relapse mortality (p < 0.0001). Elevated galectin-3 (gal-3) had a significantly adverse effect on overall survival (OS) and disease-free survival (DFS) of patients receiving standard-dose cytarabine-based consolidation chemotherapy. In multivariable analysis, gal-3 (p = 0.01), CD56 (p = 0.002), IDH1 (p = 0.007) and C-KIT (p = 0.041) were the independent unfavorable factors for OS. CD56 (p = 0.019), IDH1 (p = 0.001) and consolidation chemotherapy regimen (p = 0.041) were the independent risk factors in terms of DFS. A scoring system incorporating gal-3, CD56, IDH1 and C-KIT proved to be helpful for predicting OS in t (8;21) AML patients. Our results revealed that those carrying four factors mentioned above should be considered to be high-risk patients. © Indian Society of Hematology and Blood Transfusion 2021.