ADULT PATIENTS WITH DE-NOVO ACUTE MYELOID-LEUKEMIA AND T(9-11)(P22-Q23) HAVE A SUPERIOR OUTCOME TO PATIENTS WITH OTHER TRANSLOCATIONS INVOLVING BAND 11Q23 - A CANCER AND LEUKEMIA GROUP-B STUDY

Following reports of childhood acute myeloid leukemia (AML) showing th at patients with t(9;11)(p22;q23) have a better prognosis than those w ith translocations between 11q23 and other chromosomes, we compared re sponse to therapy and survival of 24 adult de novo AML patients with t (9;11) with those of 23 patients with other 11q23 translocations [t(11 q23)]. Apart from a higher proportion of French-American-British (FAB) M5 subtype in the t(9;11) group (83% v 43%, P = .006), the patients w ith t(9;11) did not differ significantly from patients with t(11q23) i n terms of their presenting clinical or hematologic features. Patients with t(9;11) more frequently had an extra chromosome(s) 8 or 8q as se condary abnormalities (46% v 9%, P = .008). All patients received stan dard cytarabine and daunorubicin induction therapy, and most of them a lso received cytarabine-based intensification treatment. Two patients, both with t(9;11), underwent bone marrow transplantation (BMT) in fir st complete remission (CR). Nineteen patients (79%) with t(9;11) and 1 3 (57%) with t(11q23) achieved a CR (P = .13). The clinical outcome of patients with t(9;11) was significantly better: the median CR duratio n was 10.7 versus 8.9 months (P = .02), median event-free survival was 6.2 versus 2.2 months (P = .009), and median survival was 13.2 versus 7.7 months (P = .009). All patients with t(11q23) have died, whereas seven (29%) patients with t(9;11) remain alive in first CR. Seven of e ight patients with t(9;11) who received postremission regimens with cy tarabine at a dose of 100 (four patients) or 400 mg/m(2) (2 patients) or who did not receive postremission therapy (2 patients) have relapse d. In contrast, 7 (64%) of 11 patients who received intensive postremi ssion chemotherapy with high-dose cytarabine (at a dose 3 g/m(2)) (5 p atients), or underwent BMT (2 patients) remain in continuous CR. We co nclude that the outcome of adults with de novo AML and t(9; 11) is mor e favorable than that of adults with other 11q23 translocations: this is especially true for t(9;11) patients who receive intensive postremi ssion therapy. (C) 1997 by The American Society of Hematology.