Acute Myeloid Leukemia with Core-Binding Factor Rearrangements: A 10-Year Cancer Center Experience

Abstract

Introduction: Core-binding factor-acute myeloid leukemia (CBF-AML) is characterized by t(8;21) or inv(16)/t(16;16) chromosomal rearrangements.

Methods: In this retrospective study of 71 CBF-AML cases from Qatar's National Center for Cancer Care and Research (2013-2022), we analyzed clinicopathological characteristics and survival outcomes.

Results: The cohort was predominantly male (76%) with a median age of 40 years, and 96% were de novo AML. The t(8;21) translocation was more frequent (69%) than inv(16)/t(16;16). Patients under 40 years showed higher white blood cell counts and blast percentages. Standard "3 + 7" induction chemotherapy (used in 69% of cases) achieved remission in 67% of patients. Median overall survival was 81% at 37 months, with median progression-free survival of 34 months. No significant survival differences were observed based on FLT3-ITD status, translocation type, complex karyotype, KIT mutation status, or allogeneic stem cell transplantation (performed in 19% of patients), though patients under 60 years demonstrated better survival outcomes.

Conclusions: This study highlights CBF-AML heterogeneity and challenges established prognostic markers, suggesting a need for risk stratification reassessment, treatment strategy optimization, ELN guideline implementation, and continuous molecular monitoring.

Keywords: Chromosomal translocations; Core-binding factor-acute myeloid leukemia; Prognostic factors; Risk stratification; Survival outcomes.