Clinical features, epidemiology, and survival of patients with core binding factor acute myeloid leukemia in the SEER database

Abstract

Core binding factor acute myeloid leukemia (CBF-AML) (RUNX1::RUNX1T1 or CBFB::MYH11) is a favorable-risk but heterogenous subtype of acute myeloid leukemia (AML). However, understanding of its epidemiology, clinical characteristics, and prognosis is limited. A total of 70,912 records of adults with AML, including 947 with CBFB::MYH11 and 1,285 with RUNX1::RUNX1T1 CBF-AML were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2023) and analyzed. Incidence trends were assessed using the annual percent change (APC); prognostic factors were identified using multivariable Cox regression; and survival was compared between groups using the Kaplan–Meier method. The CBFB::MYH11 and RUNX1::RUNX1T1 subtypes accounted for 1.3% and 1.8% of cases of AML, respectively, and incidence was higher in men and adults aged < 60 years. The incidence of CBF-AML increased significantly during the study period (APC 2.84% for CBFB::MYH11 and 2.89% for RUNX1::RUNX1T1 subtypes). Sex, age, and chemotherapy were independent predictors of overall survival (OS) in both subtypes. Second malignant neoplasm (SMN) was associated with poorer cancer-specific survival (CSS), and radiotherapy was associated with poorer OS in patients with RUNX1::RUNX1T1 AML. Patients with CBFB::MYH11 AML had longer OS and CSS than those with RUNX1::RUNX1T1 AML, but CSS did not differ significantly by subtype in patients aged ≥ 60 years. Untreated patients had a median OS of 1 month. The prognosis of CBF-AML is generally favorable but differs by subtype. Age, chemotherapy, and SMN are key predictors of survival. Timely diagnosis and initiation of chemotherapy is critical, especially in older patients.

The authors' abstract, as published at the source. Scientific Reports, 2026 · DOI ↗