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Characteristics and outcome of t(8;21)-positive childhood acute myeloid leukemia: a single institution's experience

Leukemia volume 16, pages 2072–2077 (2002)Cite this article

Abstract

To elucidate the clinical and biological features of childhood acute myeloid leukemia (AML) with the t(8;21), we reviewed the records of patients with AML treated at St Jude Children's Research Hospital over a 17-year period (1980 to 1996). Of 298 patients with AML, 40 (13%) had blast cells that contained the t(8;21). This translocation was associated with a high frequency of French–American–British M2 morphology (82%) and the presence of granulocytic sarcoma (23%). Molecular analysis detected the AML1-ETO fusion transcript in all 25 cases with the t(8;21) tested, but failed to identify additional cases with AML1-ETO among the 127 cases with other cytogenetic findings. Compared to patients with other genetic abnormalities, those with the t(8;21) were less likely to have internal tandem duplications of the FLT3 gene (none of 10 vs 16 of 68). The 6-year overall survival estimate was 55% ± 9% and the event-free survival estimate, 33% ± 7%. Of the clinical and biological features examined, only gender was prognostically significant: the 6-year overall survival estimate for males was 68% ± 10%, compared to 33% ± 11 for female patients (P = 0.03). Treatment outcome was not influenced by the chemotherapy regimen used or by the use of autologous hematopoietic stem cell transplantation. These results suggest that t(8;21)-positive AML represents a heterogeneous disease with variable outcome. The reported favorable outcome for t(8;21)-positive AML in other studies may be due to the use of high-dose cytarabine.

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Acknowledgements

We thank Flo Witte for expert editorial review and Annette Stone for assistance in data collection. This work was supported by grants CA-20180 and CA-21765 from the National Institutes of Health, 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, Memphis, TN, USA

    JE Rubnitz, AR Halbert, BI Razzouk, C-H Pui & RC Ribeiro

  2. Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA

    SC Raimondi, JR Downing & FG Behm

  3. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA

    X Tong & DK Srivastava

  4. Department of Pediatrics, University of Tennessee College of Medicine, Memphis, TN, USA

    JE Rubnitz, BI Razzouk, C-H Pui & RC Ribeiro

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Rubnitz, J., Raimondi, S., Halbert, A. et al. Characteristics and outcome of t(8;21)-positive childhood acute myeloid leukemia: a single institution's experience. Leukemia 16, 2072–2077 (2002). https://doi.org/10.1038/sj.leu.2402633

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