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Impact of treatment on the outcome of acute myeloid leukemia with inversion 16: a single institution's experience

Leukemia volume 15, pages 1326–1330 (2001)Cite this article

Abstract

To identify treatment factors that may affect the survival of children with inv(16)(p13.1q22), we compared the outcomes of 19 patients with this genetic feature treated at our institution during two treatment eras. Nine patients were treated during era 1 (1980 to 1987), and 10 were treated during era 2 (1988 to 1996). All entered complete remission (CR) with induction therapy. Eight of the nine children treated in era 1 died, seven of relapsed leukemia. In contrast, three of 10 patients treated during era 2 have died, all of non-disease-related causes. Event-free survival (EFS) estimates were significantly higher for patients treated during era 2 than for those treated during era 1 (P = 0.03); the 6-year estimates were 70 ± 15% (s.e.) and 11 ± 7%, respectively. Era 2 treatment protocols differed from those of era 1 in their use of higher doses of cytarabine and etoposide during induction and consolidation chemotherapy and in their use of 2-chlorodeoxyadenosine (2-CDA). These results suggest that dose intensification of cytarabine benefits children with AML and inv(16), as is the case in adults. They also suggest that dose intensification of etoposide and addition of 2-CDA may also offer an advantage. This study underscores the dependence of the prognostic impact of cytogenetic features on the efficacy of treatment.

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Acknowledgements

We thank Sharon H Naron for editorial assistance and Mary Heim-Green for data management. This work was supported by grants CA21765 and CA20180 from the National Cancer Institute, by a Center of Excellence grant from the State of Tennessee, and by the American Lebanese Syrian Associated Charities (ALSAC).

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Authors and Affiliations

  1. Department of Hematology-Oncology, St Jude Children's Research Hospital and Department of Pediatrics, College of Medicine, University of Tennessee-Memphis, Memphis, TN, USA

    BI Razzouk, M Pritchard, JT Sandlund, JE Rubnitz, C-H Pui & RC Ribeiro

  2. Department of Biostatistics, St Jude Children's Research Hospital and Department of Pediatrics, College of Medicine, University of Tennessee-Memphis, Memphis, TN, USA

    DK Srivastava & X Tong

  3. Department of Pathology, St Jude Children's Research Hospital and Department of Pediatrics, College of Medicine, University of Tennessee-Memphis, Memphis, TN, USA

    SC Raimondi, FG Behm & C-H Pui

  4. St Jude Children's Research Hospital and Department of Pediatrics, International Outreach Program, College of Medicine, University of Tennessee-Memphis, Memphis, TN, USA

    BI Razzouk, C-H Pui & RC Ribeiro

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  1. BI Razzouk
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Razzouk, B., Raimondi, S., Srivastava, D. et al. Impact of treatment on the outcome of acute myeloid leukemia with inversion 16: a single institution's experience. Leukemia 15, 1326–1330 (2001). https://doi.org/10.1038/sj.leu.2402215

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