CHARACTERISTICS AND OUTCOME OF T(8;21)-POSITIVE CHILDHOOD ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION'S EXPERIENCE

Compared with other cytogenetic acute myeloid leukemia (AML) groups, patients with core-binding factor AML (CBF-AML) are considered as a favorable AML risk group based on their high remission rate and survival probabilities. However, up to 30-40% of these patients can still relapse after standard intensive induction and consolidation chemotherapy. From 2004 to 2020, 147 AML patients reviewed. Ten of 147 patients were followed up with t(8;21) chromosomal anomaly. The t(8;21)(q22;q22) was detected by reverse transcription polymerase chain reaction (RT-PCR) and/or floresan in situ hibridizasyon (FISH). We analyzed patients’ demographic data: sex, white blood cell count at diagnosis, central nervous system status, additional cytogenetic anomaly and recurrence rates, stem cell transplant status and survival rates. Two of 10 patients were female. The median age was 10 years (3-17 years). Median followup was 36 months (2-114 months). The mean white blood cell count of 10 patients was 21.5 (× 109/l) at diagnosis. One out of 10 patients had granulocytic sarcoma and 2 had central nervous system involvement. Additional cytogenetic anomalies were detected in 90% of the patients, of which 2 relapsed and 3 died. One patient received hematopoietic stem cell transplantation and died because of HSCT complications. Recent studies show that CBF-AML includes different groups with different clinical outcomes. We found that 50% of our patients achieved complete remission and 50% experienced relapsed disease or death. After we were able to monitor the t(8;21) level with RT-PCR, we diagnosed relapsed disease in 1 patient with additional cytogenetic anomaly. RT-PCR is essential for optimal handling of these patients to predict patients’ relapse risk and to detect minimal residual disease.