Clinical characteristics and prognosis of core binding factor positive acute myeloid leukemia in children

Abstract

Objective To explore the clinical characteristics and prognosis of core binding factor(CBF)positive acute myeloid leukemia(AML)in children. Methods Eighty-five children with AML who were not acute promyelocytic leukemia (APL) and Downs syndrome were enrolled in this study and received more than one course of chemotherapy from Jun.2007 to Jun. 2012 in Children's Hospital of Soochow University.They were divided into low-risk group, medium-risk group, high-risk group according to national unity stratification criteria to confirm their survival condition, analyze the effection of prognosis of sex, FAB type, initial white blood cell number, CBF, chromosome, complete remission course, central nervous system leukemia(CNSL), relapse, hematopoietic stem cell transplantation(HSCT). Forty cases with CBF positive AML were evaluated with Kaplan-Meier survival curves of 5-year overall survival(OS) rate and event-free survival(EFS) rate, CBF negative AML as control group. Results Five-year OS rates of low-risk, intermediate-risk and high-risk group were (66.5±11.6)%, (54.5±14.4)% and(42.7±7.2)% respectively, there was significant difference(χ2=6.085, P=0.048); and the 5-year EFS rates were (62.2±14.0)%, (54.5±14.4)% and(41.9±7.3)% respectively, there was no significant difference(χ2=1.060, P=2.589). Cases of distribution of CBF positive AML were 22/23 cases in low-risk group, 3/11 cases in medium-risk group and 15/51 cases in high-risk group.Twenty-three cases survived in CBF positive AML group, 24 cases survived in control group, and their 5-year OS rates were(51.8 ± 8.8)%, (50.6±7.6)%, respectively.Ten cases relapsed, including 6 cases with CBF positive(3 cases death) and 4 control cases(2 cases death). Twenty cases received HSCT, including 5 cases with CBF positive (1 case death) and 15 control cases(3 cases death). COX regression multivariate analysis showed that gender, numbers of course of induction chemotherapy to remission and HSCT were individually statistic significance for pediatric AML's prognosis while the FAB classification, initial leukocyte count and central nervous system leukemia had no effect on prognosis. Conclusions There is no significantly statistic difference between CBF positive AML and its control in chemotherapy group.The survival rate in control group and all cases in pediatric AML could be obviously improved by HSCT. Key words: Core binding factor; Leukemia; Myeloid; Acute; Prognosis; Child