Core-binding factor acute myeloid leukemia with t(8;21): Risk factors and a novel scoring system (I-CBFit)

Celalettin Ustun, Elizabeth Morgan, Erica E.M. Moodie, Sheeja Pullarkat, Cecilia Yeung, Sigurd Broesby-Olsen, Robert Ohgami, Young Kim, Wolfgang Sperr, Hanne Vestergaard, Dong Chen, Philip M. Kluin, Michelle Dolan, Krzysztof Mrózek, David Czuchlewski, Hans Peter Horny, Tracy I. George, Thomas Kielsgaard Kristensen, Nam K. Ku, Cecilia Arana YiMichael Boe Møller, Guido Marcucci, Linda Baughn, Ana Iris Schiefer, J. R. Hilberink, Vinod Pullarkat, Ryan Shanley, Jessica Kohlschmidt, Janie Coulombe, Amandeep Salhotra, Lori Soma, Christina Cho, Michael A. Linden, Cem Akin, Jason Gotlib, Gregor Hoermann, Jason Hornick, Ryo Nakamura, Joachim Deeg, Clara D. Bloomfield, Daniel Weisdorf, Mark R. Litzow, Peter Valent, Gerwin Huls, Miguel Angel Perales, Gautam Borthakur

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Although the prognosis of core-binding factor (CBF) acute myeloid leukemia (AML) is better than other subtypes of AML, 30% of patients still relapse and may require allogeneic hematopoietic cell transplantation (alloHCT). However, there is no validated widely accepted scoring system to predict patient subsets with higher risk of relapse. Methods: Eleven centers in the US and Europe evaluated 247 patients with t(8;21)(q22;q22). Results: Complete remission (CR) rate was high (92.7%), yet relapse occurred in 27.1% of patients. A total of 24.7% of patients received alloHCT. The median disease-free (DFS) and overall (OS) survival were 20.8 and 31.2 months, respectively. Age, KIT D816V mutated (11.3%) or nontested (36.4%) compared with KIT D816V wild type (52.5%), high white blood cell counts (WBC), and pseudodiploidy compared with hyper- or hypodiploidy were included in a scoring system (named I-CBFit). DFS rate at 2 years was 76% for patients with a low-risk I-CBFit score compared with 36% for those with a high-risk I-CBFit score (P < 0.0001). Low- vs high-risk OS at 2 years was 89% vs 51% (P < 0.0001). Conclusions: I-CBFit composed of readily available risk factors can be useful to tailor the therapy of patients, especially for whom alloHCT is not need in CR1 (ie, patients with a low-risk I-CBFit score).

Original languageEnglish (US)
Pages (from-to)4447-4455
Number of pages9
JournalCancer medicine
Issue number9
StatePublished - Sep 2018

Bibliographical note

Publisher Copyright:
© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.


  • KIT mutation
  • acute myeloid leukemia
  • core-binding factor
  • disease-free survival
  • predictive value
  • relapse
  • scoring system


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