Lee Keun-Wook, Choi In Sil, Roh Eun Youn, Kim Dae-Young, Yun Tak, Lee Dong Soon, Yoon Sung-Soo, Park Seonyang, Kim Byoung Kook, Kim Noe Kyeong
Department of Internal Medicine, Seoul National University Hospital and College of Medicine, 28 Yongon-Dong, Chongno-Gu, 110-744 Seoul, Republic of Korea.
Ann Hematol. 2004 Apr;83(4):218-24. doi: 10.1007/s00277-003-0811-1. Epub 2003 Nov 20.
Clinical features and treatment outcome of 31 patients over 16 years of age with t(8;21) acute myeloid leukemia (AML) were compared with 60 patients without t(8;21). Among 31 patients with t(8;21), 15 patients were classified as AML-M2 and 11 and 5 patients as AML-M4 and M1, respectively. Of these patients, 28 patients (90.3%) achieved complete remission and 22 patients received consolidative treatment: intermediate-dose cytarabine (IDAC) 11, high-dose cytarabine (HDAC) 6, and allogeneic bone marrow transplantation (BMT) 5. When compared with patients without t(8;21), we could not demonstrate better treatment outcome for t(8;21) AML [median event-free survival (EFS) and overall survival (OS) 10.3 and 12.5 months in AML with t(8;21) vs 11.5 and 15.6 months in AML without t(8;21)]. In the t(8;21) AML group, patients who received HDAC consolidation did not show superior treatment outcome to those who received other consolidative treatment [median EFS: IDAC 11.9 months vs HDAC 9.2 months vs allogeneic BMT 38.1 months (P=NS) and median OS: IDAC 17.8 months vs HDAC 12.0 months vs allogeneic BMT 47.3 months (P=NS)]. Similar treatment outcome between patients with and without t(8;21) and non-superior treatment outcome of HDAC consolidative chemotherapy in the t(8;21) AML group in our study is contradictory to previous reports.
将31例16岁以上伴t(8;21)急性髓系白血病（AML）患者的临床特征及治疗结果与60例不伴t(8;21)的患者进行了比较。在31例伴t(8;21)的患者中，15例被分类为AML-M2，11例和5例分别为AML-M4和M1。这些患者中，28例（90.3%）实现完全缓解，22例患者接受了巩固治疗：11例接受中剂量阿糖胞苷（IDAC），6例接受高剂量阿糖胞苷（HDAC），5例接受异基因骨髓移植（BMT）。与不伴t(8;21)的患者相比，我们未能证明伴t(8;21)的AML有更好的治疗结果[伴t(8;21)的AML的无事件生存期（EFS）和总生存期（OS）中位数分别为10.3个月和12.5个月，而不伴t(8;21)的AML分别为11.5个月和15.6个月]。在伴t(8;21)的AML组中，接受HDAC巩固治疗的患者与接受其他巩固治疗的患者相比，未显示出更好的治疗结果[EFS中位数：IDAC为11.9个月，HDAC为9.2个月，异基因BMT为38.1个月（P=无显著性差异）；OS中位数：IDAC为17.8个月，HDAC为12.0个月，异基因BMT为47.3个月（P=无显著性差异）]。我们研究中伴t(8;21)和不伴t(8;21)的患者之间相似的治疗结果以及伴t(8;21)的AML组中HDAC巩固化疗的非优越治疗结果与先前的报道相矛盾。
