Factors associated with risk of central nervous system relapse in patients with non-core binding factor acute myeloid leukemia

Elias Jabbour, Naval Guastad Daver, Nicholas James Short, Xuelin Huang, Hsiang Chun Chen, Abhishek Maiti, Farhad Ravandi, Jorge Cortes, Simon Abi Aad, Guillermo Garcia-Manero, Zeev Estrov, Tapan Kadia, Susan O'Brien, Bouthaina Dabaja, Carlos Bueso-Ramos, Paolo Strati, Carol Bivins, Sherry Pierce, Hagop Kantarjian

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2 Scopus citations

Abstract

Central nervous system (CNS) relapse is uncommon in patients with acute myeloid leukemia (AML) with the use of high-dose cytarabine containing chemotherapy regimens. The clinical and molecular features associated with a higher risk of CNS relapse are not well defined. We assessed the incidence and outcome of CNS relapses among 1245 patients with relapsed/refractory AML referred to our institution between 2000 and 2014. CNS leukemia relapse was observed in 51 patients (4.1%). Using a multivariate regression model and after adjusting for age, FLT3-ITD mutation (OR = 2.33; P =.02) and elevated LDH (>1000 IU/L, OR = 1.99; P =.04) were independent predictive factors for CNS relapse. Patients under 64 years of age with 0, 1, or 2 baseline adverse features had a probability of 3.8%, 7.0%-8.0%, and 13.9% for developing CNS disease, respectively. Our study identifies patients with AML at higher risk for CNS relapse in whom prophylactic CNS therapy may be warranted.

Original languageEnglish (US)
Pages (from-to)924-928
Number of pages5
JournalAmerican Journal of Hematology
Volume92
Issue number9
DOIs
StatePublished - Sep 2017
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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    Jabbour, E., Guastad Daver, N., Short, N. J., Huang, X., Chen, H. C., Maiti, A., Ravandi, F., Cortes, J., Abi Aad, S., Garcia-Manero, G., Estrov, Z., Kadia, T., O'Brien, S., Dabaja, B., Bueso-Ramos, C., Strati, P., Bivins, C., Pierce, S., & Kantarjian, H. (2017). Factors associated with risk of central nervous system relapse in patients with non-core binding factor acute myeloid leukemia. American Journal of Hematology, 92(9), 924-928. https://doi.org/10.1002/ajh.24799