Favorable subset of acute myeloid leukemia with translocation 8;21: An elusive experience

Background: Risk stratification is critical in the management of acute myeloid leukemia (AML) and among the favorable subset translocations known, 8;21 seems elusive in our clinical practice as regards the response remission status. This led us to review our patients retrospectively to highlight this ambiguity. Patients and Methods: A retrospective study was carried out on a total of 20 patients positive for translocation (8;21) and negative for FLT3 and NPM gene mutation. These patients were treated with standard AML treatment protocols. Post induction day 14 and day 28 assessments were done. Four patients died during induction chemotherapy and all the remaining patients were in remission. Subsequently, these patients were subjected to consolidation chemotherapy. Results: Out of total of 16 (80%) survivors, 10 (50%) could not maintain the remission status on a mean follow-up of 6 months and were treated with a different induction protocol. After the second induction, all patients were in remission at day 28, but this remission again was short lasting ( Conclusion: One needs to be careful in treatment of AML with translocation (8;21) and this should not be taken as a single criterion for treatment of these patients. These patients should be subjected to additional somatic mutation analysis before final risk stratification.