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Extramedullary leukemia adversely affects hematologic complete remission rate and overall survival in patients with t(8;21)(q22;q22): results from Cancer and Leukemia Group B 8461.

Publication ,  Journal Article
Byrd, JC; Weiss, RB; Arthur, DC; Lawrence, D; Baer, MR; Davey, F; Trikha, ES; Carroll, AJ; Tantravahi, R; Qumsiyeh, M; Patil, SR; Moore, JO ...
Published in: J Clin Oncol
February 1997

PURPOSE: To examine the prognostic significance of extramedullary leukemia (EML) at presentation in patients with t(8;21)(q22;q22) karyotype. PATIENTS AND METHODS: Consecutive patients with t(8;21) treated on Cancer and Leukemia Group B de novo acute myeloid leukemia (AML) treatment studies were examined for the presence of EML (granulocytic sarcoma, subcutaneous nodules, leukemia cutis, or meningeal leukemia) at initial presentation. Clinical features and outcome of t(8;21) patients with and without EML were compared. RESULTS: Of 84 patients with t(8;21), eight (9.5%) had EML manifesting as granulocytic sarcoma (five paraspinal, one breast, and one subcutaneous) or symptomatic meningeal leukemia (n = 1). The pretreatment prognostic variables of t(8;21) patients with and without EML were similar. The hematologic complete remission (CR) rate for t(8;21) patients with EML was 50% versus 92% for those without EML (P=.006). The median CR duration for EML patients was 14.7 months. Patients with EML had a shorter survival (P = 0.002, median 5.4 months versus 59.5 months). This poor outcome may relate to inadequate local (radiation or intrathecal) therapy for patients with spinal or meningeal EML, resulting in residual/recurrent EML following induction chemotherapy (n = 2) or at relapse (n = 1) and permanent neurologic deficits (n = 4). Only one of the EML patients received high-dose cytarabine (HDAC) intensification; this is the only EML patient remaining alive in CR. CONCLUSION: Patients with t(8;21) and EML have a low CR rate and overall survival. An aggressive local and systemic induction therapy should be considered for this patient subset. The effectiveness of HDAC intensification in t(8;21) patients with EML is uncertain and warrants further study.

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Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 1997

Volume

15

Issue

2

Start / End Page

466 / 475

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Translocation, Genetic
  • Survival Analysis
  • Remission Induction
  • Prognosis
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Neoplasms, Multiple Primary
  • Middle Aged
  • Meningeal Neoplasms
 

Citation

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Byrd, J. C., Weiss, R. B., Arthur, D. C., Lawrence, D., Baer, M. R., Davey, F., … Bloomfield, C. D. (1997). Extramedullary leukemia adversely affects hematologic complete remission rate and overall survival in patients with t(8;21)(q22;q22): results from Cancer and Leukemia Group B 8461. J Clin Oncol, 15(2), 466–475. https://doi.org/10.1200/JCO.1997.15.2.466
Byrd, J. C., R. B. Weiss, D. C. Arthur, D. Lawrence, M. R. Baer, F. Davey, E. S. Trikha, et al. “Extramedullary leukemia adversely affects hematologic complete remission rate and overall survival in patients with t(8;21)(q22;q22): results from Cancer and Leukemia Group B 8461.J Clin Oncol 15, no. 2 (February 1997): 466–75. https://doi.org/10.1200/JCO.1997.15.2.466.
Byrd, J. C., et al. “Extramedullary leukemia adversely affects hematologic complete remission rate and overall survival in patients with t(8;21)(q22;q22): results from Cancer and Leukemia Group B 8461.J Clin Oncol, vol. 15, no. 2, Feb. 1997, pp. 466–75. Pubmed, doi:10.1200/JCO.1997.15.2.466.
Byrd JC, Weiss RB, Arthur DC, Lawrence D, Baer MR, Davey F, Trikha ES, Carroll AJ, Tantravahi R, Qumsiyeh M, Patil SR, Moore JO, Mayer RJ, Schiffer CA, Bloomfield CD. Extramedullary leukemia adversely affects hematologic complete remission rate and overall survival in patients with t(8;21)(q22;q22): results from Cancer and Leukemia Group B 8461. J Clin Oncol. 1997 Feb;15(2):466–475.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 1997

Volume

15

Issue

2

Start / End Page

466 / 475

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Translocation, Genetic
  • Survival Analysis
  • Remission Induction
  • Prognosis
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Neoplasms, Multiple Primary
  • Middle Aged
  • Meningeal Neoplasms