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BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Risk factors and clinical outcomes of acute myeloid leukaemia with central nervous system involvement in adults

Authors: Chieh-Lung Cheng, Chi-Cheng Li, Hsin-An Hou, Wei-Quan Fang, Chin-Hao Chang, Chien-Ting Lin, Jih-Luh Tang, Wen-Chien Chou, Chien-Yuan Chen, Ming Yao, Shang-Yi Huang, Bor-Sheng Ko, Shang-Ju Wu, Woei Tsay, Hwei-Fang Tien

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Acute myeloid leukaemia (AML) with central nervous system (CNS) involvement in adults is uncommon, and studies of this subject are scant.

Methods

We conducted a retrospective study to investigate the clinical aspects, cytogenetic abnormalities, molecular gene mutations and outcomes of adult AML patients with CNS involvement. Three hundred and ninety-five patients with newly diagnosed AML were reviewed.

Results

Twenty (5.1%) patients had CNS involvement, including 7 (1.8%) with initial CNS disease and 4 (1%) who suffered an isolated CNS relapse. The patients with CNS involvement were younger, had higher leukocyte, platelet, and peripheral blast cell counts, FAB M4 morphology, and chromosome translocations involving 11q23 (11q23 abnormalities) more frequently than did the patients without CNS involvement. No differences in sex, haemoglobin levels, serum LDH levels, immunophenotype of leukaemia cells, or molecular gene mutations were observed between the two groups. Multivariate analyses showed that age ≤ 45 years (OR, 5.933; 95% CI, 1.82 to 19.343), leukocyte counts ≥ 50,000/μl (OR, 3.136; 95% CI, 1.083 to 9.078), and the presence of 11q23 abnormalities (OR, 5.548; 95% CI, 1.208 to 25.489) were significant predictors of CNS involvement. Patients with initial CNS disease had 5-year overall survival and relapse-free survival rates that were similar to those without initial CNS disease. However, three of four patients who suffered an isolated CNS relapse died, and their prognosis was as poor as that of patients who suffered a bone marrow relapse.

Conclusion

CNS involvement in adult patients with AML is rare. Three significant risk factors for CNS involvement including age ≤ 45 years, leukocyte counts ≥ 50,000/μl and the presence of 11q23 abnormalities were identified in this study. Future investigations to determine whether adult AML patients having these specific risk factors would benefit from CNS prophylactic therapy are necessary.
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Metadata
Title
Risk factors and clinical outcomes of acute myeloid leukaemia with central nervous system involvement in adults
Authors
Chieh-Lung Cheng
Chi-Cheng Li
Hsin-An Hou
Wei-Quan Fang
Chin-Hao Chang
Chien-Ting Lin
Jih-Luh Tang
Wen-Chien Chou
Chien-Yuan Chen
Ming Yao
Shang-Yi Huang
Bor-Sheng Ko
Shang-Ju Wu
Woei Tsay
Hwei-Fang Tien
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1376-9

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