Factors associated with risk of central nervous system relapse in patients with non‐core binding factor acute myeloid leukemia |
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| Authors: | 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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| Affiliation: | 1. Departments of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas;2. Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas;3. Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;4. Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas |
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| 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. |
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