تسجيل الدخول

تسجيل

Prognostic Factors for Acute Myeloid Leukemia in First Complete Remission

المؤلف:  Hoffman, R., Benz, E. J., Silberstein, L. E., Heslop, H., Weitz, J., & Salama, M. E.

المصدر:  Hematology : Basic Principles and Practice

الجزء والصفحة:  8th E , P1002

2026-10-25

9

 Good-Risk Acute Myeloid Leukemia

 In general, the 15% to 20% of AML patients with core binding fac tor (CBF) leukemia—t(8;21) (q22;q22) and inv(16)(p13.q22)—are considered to have good-risk disease, with a long-term disease-free survival of approximately 50% to 60% after consolidation chemotherapy, and allogeneic HSCT is not routinely recommended for patients achieving CR1. However, retrospective studies have identified activating mutations in C-KIT (mKIT)—a member of the type III receptor tyrosine kinase family—at exon 17 (mKIT 17) or exon 8 (mKIT 8) in approximately 30% of CBF AMLs, in particular AML with t(8;21), that are associated with increased relapse incidence and likely poorer survival, especially if higher mutant KIT levels are present. Consensus opinions differ on the implications: ELN guidelines suggest that occurrence of a KIT mutation should not assign a patient to a different risk category; rather, patients should be monitored for MRD, whose absence can abrogate the effect of KIT. 2019 guidelines of the US National Comprehensive Cancer Network (NCCN) in contrast highlight considering them for clinical trials targeting the molecular abnormality, or for referral to allogeneic transplantation.