A glimpse into translocation (8;21) in acute myeloid leukemia: Profile and therapeutic outcomes from a tertiary care hematology center from East India

Abstract

Objectives: Translocation (8;21) is a RUNX1-RUNX1T1 fusion transcript, a favorable risk cytogenetic abnormality with a variable clinicopathological profile. However, there is a paucity of data on the outcomes of acute myeloid leukemia (AML) with t(8;21) from East India. This report is an analysis of data of AML with t(8;21) at our center. Material and Methods: De novo AML patients with the presence of t(8;21) cytogenetic abnormality from 2015 to 2019 were analyzed for clinical, pathological, and molecular characteristics and were compared with treatment outcomes. Relapse-free survival (RFS) and overall survival (OS) were determined using Kaplan–Meier curves. Results: Twenty-nine patients (10%) with de novo AML had t(8;21) with 18 male patients and a median age of 20 years. Aberrant expression of CD19, CD56, and CD7 expressions was noted in 44.8%, 17.24%, and 10.29% of patients, respectively. Additional cytogenetic abnormality was observed in 31.03%. CD19 had an 80% correlation with the occurrence of C-kit status. High-dose induction therapy had complete remission rates of 100%. The median duration of follow-up was 287.5 days. The presence of myeloid sarcoma (MS) and C-kit positivity had inferior OS and RFS (P < 0.05). The dose of cytosine arabinoside, given in consolidation of 3 g/m2 and 1.5 g/m2, had a median OS of 758 and 479 days (P = 0.661) and median RFS of 348 and 150 days (P = 0.002), respectively. In the group that received intensive therapy, by the end of 3 years, only 15.7% of patients remain in remission. Conclusion: AML with t(8;21) is seen in young patients with a positive correlation between CD 19 with C-kit positivity. The presence of MS and C-kit positivity endowed inferior OS and RFS. Cytosine arabinoside consolidation in a dose of 3 g/m2 offered an advantage in median RFS.