Acute myelogenous leukemia with an 8;21 translocation. A report on 148 cases from the Groupe Français de Cytogénétique Hématologique

Abstract

A retrospective study of 148 previously untreated patients with acute nonlymphocytic leukemia (ANLL) presenting a t(8;21) was undertaken by the Groupe Français de Cytogénétique Hématologique (GFCH). The mean age was 30.8 years for 33 children and 115 adults, 80% of patients were under 50 years, and 66% were males. The sex ratio was unbalanced only in adults (p less than 0.05). Morphologic diagnosis was M2 in 92% of patients. Normal and abnormal mitoses were found in 45% of cases. Complex variant translocations involving 8q22, 21q22, and another chromosome had a frequency of 3.4%. In 75% of the cases additional chromosomal abnormalities were observed. Sex chromosome loss was found (73% of additional abnormalities) in 41% of females and 61% of males. Trisomy 8 was the other recurrent numerical abnormality (7.5%). Chromosome 9 was frequently involved in additional abnormalities (11%), mainly in deletions overlapping the region 9q21-22. Deletions or translocations of chromosome 7(q) were observed in 10% of the cases. The order of appearance did not follow a precise pattern. The remission rate was 90.7%. It was similar in males and females, children and adults. The median survival duration from diagnosis was 17.5 months, with a 24% probability of 5 year survival. Children had a median survival of 24 months from diagnosis, which is to be compared to 16 months for the adults (not statistically different). In no cytogenetic category was a white cell count level higher than 10 x10(9)/L associated with a poorer prognosis. It was concluded that despite the high complete remission rate in t(8;21) ANLL, when a comparison is made between patients achieving a complete remission, the 17-month median survival is similar to that reported in recently published series of ANLL.