Core-binding factor acute myeloid leukemia: can we improve on HiDAC consolidation?

Hematology Am Soc Hematol Educ Program. 2013:2013:209-19. doi: 10.1182/asheducation-2013.1.209.

Abstract

Acute myeloid leukemia (AML) with t(8;21) or inv(16) is commonly referred to as core-binding factor AML (CBF-AML). The incorporation of high-dose cytarabine for postremission therapy has substantially improved the outcome of CBF-AML patients, especially when administered in the setting of repetitive cycles. For many years, high-dose cytarabine was the standard treatment in CBF-AML resulting in favorable long-term outcome in approximately half of the patients. Therefore, CBF-AML patients are generally considered to be a favorable AML group. However, a substantial proportion of patients cannot be cured by the current treatment. Additional genetic alterations discovered in CBF-AML help in our understanding of the process of leukemogenesis and some of them may refine the risk assessment in CBF-AML and, importantly, also serve as targets for novel therapeutic approaches. We discuss the clinical and genetic heterogeneity of CBF-AML, with a particular focus on the role of KIT mutations as a prognosticator, and also discuss recent efforts to target the KIT kinase in the context of existing therapeutic regimens.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antimetabolites, Antineoplastic / therapeutic use*
  • Cell Transformation, Neoplastic / genetics
  • Cell Transformation, Neoplastic / metabolism
  • Chromosome Inversion*
  • Chromosomes, Human*
  • Cytarabine / therapeutic use*
  • Drug Delivery Systems / methods
  • Humans
  • Leukemia, Myeloid, Acute* / genetics
  • Leukemia, Myeloid, Acute* / metabolism
  • Leukemia, Myeloid, Acute* / therapy
  • Proto-Oncogene Proteins c-kit / genetics
  • Proto-Oncogene Proteins c-kit / metabolism
  • Translocation, Genetic*

Substances

  • Antimetabolites, Antineoplastic
  • Cytarabine
  • Proto-Oncogene Proteins c-kit