1
|
Matsuo H, Kajihara M, Tomizawa D, Watanabe T, Saito AM, Fujimoto J, Horibe K, Kodama K, Tokumasu M, Itoh H, Nakayama H, Kinoshita A, Taga T, Tawa A, Taki T, Tanaka S, Adachi S. Prognostic implications of CEBPA mutations in pediatric acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group. Blood Cancer J 2014; 4:e226. [PMID: 25014773 PMCID: PMC4219441 DOI: 10.1038/bcj.2014.47] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 05/19/2014] [Indexed: 11/30/2022] Open
Abstract
CCAAT/enhancer-binding protein alpha (CEBPA) mutations are a favorable prognostic factor in adult acute myeloid leukemia (AML) patients; however, few studies have examined their significance in pediatric AML patients. Here we examined the CEBPA mutation status and clinical outcomes of pediatric AML patients treated in the AML-05 study. We found that 47 (14.9%) of the 315 evaluable patients harbored mutations in CEBPA; 26 cases (8.3%) harbored a single mutation (CEBPA-single) and 21 (6.7%) harbored double or triple mutations (CEBPA-double). After excluding core-binding factor-AML cases, patients harboring CEBPA mutations showed better overall survival (OS; P=0.048), but not event-free survival (EFS; P=0.051), than wild-type patients. Multivariate analysis identified CEBPA-single and CEBPA-double as independent favorable prognostic factors for EFS in the total cohort (hazard ratio (HR): 0.47 and 0.33; P=0.02 and 0.01, respectively). CEBPA-double was also an independent favorable prognostic factor for OS (HR: 0.30; P=0.04). CEBPA-double remained an independent favorable factor for EFS (HR: 0.28; P=0.04) in the normal karyotype cohort. These results suggest that CEBPA mutations, particularly CEBPA-double, are an independent favorable prognostic factor in pediatric AML patients, which will have important implications for risk-stratified therapy.
Collapse
Affiliation(s)
- H Matsuo
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M Kajihara
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - D Tomizawa
- Department of Pediatrics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - T Watanabe
- Department of Nutritional Science, Aichi Gakuin University, Aichi, Japan
| | - A M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - J Fujimoto
- Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - K Kodama
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M Tokumasu
- Department of Pediatrics, Kyoto University, Kyoto, Japan
| | - H Itoh
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - H Nakayama
- Department of Pediatrics, National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka, Japan
| | - A Kinoshita
- Department of Pediatrics, St Marianna University School of Medicine, Kanagawa, Japan
| | - T Taga
- Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan
| | - A Tawa
- Department of Pediatrics, National Hospital Organization Osaka Medical Hospital, Osaka, Japan
| | - T Taki
- Department of Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Tanaka
- Department of Pharmacoepidemiology, Kyoto University, Kyoto, Japan
| | - S Adachi
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| |
Collapse
|
2
|
Kim SW, Mori SI, Tanosaki R, Fukuda T, Kami M, Sakamaki H, Yamashita T, Kodera Y, Terakura S, Taniguchi S, Miyakoshi S, Usui N, Yano S, Kawano Y, Nagatoshi Y, Harada M, Morishima Y, Okamoto S, Saito AM, Ohashi Y, Ueda R, Takaue Y. Busulfex (i.v. BU) and CY regimen before SCT: Japanese-targeted phase II pharmacokinetics combined study. Bone Marrow Transplant 2008; 43:611-7. [DOI: 10.1038/bmt.2008.372] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
3
|
Saito AM, Zahrieh D, Cutler C, Ho VT, Antin JH, Soiffer RJ, Alyea EP, Lee SJ. Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy. Bone Marrow Transplant 2007; 40:209-17. [PMID: 17563734 DOI: 10.1038/sj.bmt.1705733] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We compared inpatient and outpatient costs alongside clinical outcomes associated with hematopoietic cell transplantation between 2000 and 2003 with high-dose regimens (HDCT, n=185) and with reduced intensity regimens (RICT, n=90) from human leukocyte antigen (HLA)-matched donors for patients with hematological malignancies. With a comparable median follow-up of 3 years, long-term clinical outcomes, including cumulative incidence of chronic graft-vs-host disease, disease-free survival and overall survival, were similar between the two groups. In the univariate analysis, median costs for the first 100 days ($104,380 vs $42,149) and 1 year ($128,253 vs $80,499) in the HDCT group were higher than those in the RICT group. Median days of hospitalization are also higher for HDCT recipients (39 vs 21), although the number of outpatient clinic visits for HDCT recipients were fewer compared to that for RICT recipients (16 vs 25) during the first year. Adjusting for patient characteristics, RICT recipients had approximately 16 fewer days of hospitalization and cost $53,030 less than HDCT recipients within the first year after transplantation. Our data suggest that substantially lower costs and fewer days of hospitalization within the first year after RICT procedures can be obtained with no compromise of long-term clinical outcomes compared to HDCT procedures.
Collapse
Affiliation(s)
- A M Saito
- Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
| | | | | | | | | | | | | | | |
Collapse
|