Isolated trisomy of chromosomes 8, 11, 13 and 21 is an adverse prognostic factor in adults with de novo acute myeloid leukemia: Results from Cancer and Leukemia Group B 8461
Isolated trisomy is a relatively common cytogenetic abnormality in acute myeloid leukemia (AML), but with uncertain prognostic significance. We studied a large cohort of newly diagnosed de novo AML patients karyotyped on CALGB 8461 from 1984-1999, where trisomy was the sole abnormality.
The common isolated trisomies (ITC), +8, +11, +13 and +21, comprised 90% of all sole trisomies. The outcome of 101 ITC patients was compared to that of 976 with normal and cytogenetics. The overall survival (OS) for ITC patients was unsatisfactory with 10% [95% confidence
interval (CI), 3-17%] alive at 5 years. Repeated cycles of I/HDAC intensification did not improve outcome. However, SCT significantly improved relapse-free survival (RFS). Among ITC patients <60 years in first remission, only 1 of 7 receiving SCT relapsed, compared to 16 of 19 patients
treated with chemotherapy only. The prognosis of ITC was dependent on SCT. For non-transplanted patients, the 5-year OS for ITC was 5% (95% CI, 0-11%), compared to 20% (95% CI, 16-23%) for 640 normal cytogenetics patients. ITC was an independent adverse prognostic factor for OS in non-transplanted
patients. In those receiving SCT, however, the 5-year OS for ITC patients (69%, 95% CI, 32-100%) was not different to that of transplanted normal cytogenetics patients (60%, 95% CI, 38-81%). We conclude that in de novo adult AML patients not receiving SCT, ITC appears to independently predict
a poor outcome that may be improved with SCT in first remission. Prospective studies are required to confirm this hypothesis.
Document Type: Research Article
Affiliations: Division of Hematology and Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA., Email: [email protected]
Publication date: 01 November 2002
- The International Journal of Oncology provides an international forum for the publication of the latest, cutting-edge research in the broad area of oncology and cancer treatment. The journal accepts original high quality works and reviews on all aspects of oncology research including carcinogenesis, metastasis, epidemiology, chemotherapy and viral oncology. Through fair and efficient peer review, the journal is dedicated to publishing top tier research in the field, offering authors rapid publication as well as high standards of copy-editing and production. The International Journal of Oncology is published on a monthly basis in both print and early online.
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