Prognostic Significance of Chromosome Analysis in De Novo Acute Myeloid Leukemia

Weh, H. J.; Hoffmann, Rüdiger; Suciu, Stefan; Ritter, J.; Kuse, R.; Hossfeld, Dieter K.

doi:10.1007/978-3-642-74643-7_28

Cited by 14 publications

(2 citation statements)

References 41 publications

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“…The prognostic significance of cytogenetics is therefore important to evaluate. Several studies have shown that survival, in treated AML patients, significantly decreased when, respectively, normal metaphases only (NN), and admixture of normal and abnormal metaphases (AN) and abnormal metaphases only (AA) (Berger et al, 198 7b;FIWCL, 1984;Lindquist et al 1988;Weh et al, 1988) were present. Recent reports have focussed on the prognostic value associated with recurring 'specific' chromosome rearrangements found in AML (FIWCL, 1987;Berger et d, 1987b;Keating et al, 1988;Schiffer et al, 1989;Bloomfield, 1988).…”

Section: Resultsmentioning

confidence: 99%

“…Sakurai & Sandberg first reported the influence of cytogenetics on outcome in AML. Recently, several large reports have attempted to determine more precisely the prognosis associated with each of the specific cytogenetic abnormalities encountered in AML (Berger et al 1987b;FIWCL, 1984: Keating et al, 1988Schiffer et al, 1989: Shirrington et al, 1988Weh et al 1988;Yashiga et al, 1988 found that inv 16, t(8;21) and t(15;17) were 'favourable' for response to therapy and/or remission duration, whereas patients with a normal karyotype had an intermediate prognosis and all the other karyotypic abnormalities carried a poor prognosis.…”

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confidence: 99%

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Cytogenetics and their prognostic value in de novo acute myeloid leukaemia: a report on 283 cases

Fenaux¹,

Preudhomme²,

Laı̈

et al. 1989

Br J Haematol

180

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Cytogenetic analysis was successfully performed at diagnosis in 283 patients with de novo acute myeloid leukaemia (AML), including eight children aged 6-15 and 275 adults. Mean age was 50.3 (range 6-86) and the M/F ratio was 1.23. 214 patients were treated by intensive chemotherapy and 75.2% achieved complete remission. Patients with inv(16) and t(8;21) had very high CR rates whereas those with complex cytogenetic abnormalities (with or without involvement of chromosomes 5 and/or 7) had a poor response to therapy. Other karyotypic abnormalities and normal karyotypes were associated with intermediate CR rates. In a multivariate analysis, cytogenetics were the best prognostic factor of the achievement of CR, followed by age and platelet count. Median actuarial disease-free survival (DFS) of the patients who achieved CR was 19 months. No significant differences in actuarial DFS were found according to karyotype. However, no relapses were seen in patients with inv(16) and t(9;11) or its variants. Conversely, the median DFS was only 12.5 months in patients with t(15;17). Median actuarial DFS was 24 months in patients with t(8;21), but a high incidence of early relapses were seen, and the actuarial DFS was only 54% at 12 months. Patients with trisomy 8 also had a median actuarial DFS of 24 months. Our findings do not support the previously reported 'favourable' prognosis of t(15;17) translocations. They suggest that, although it is characterized by a high CR rate, t(8;21) might be associated with a high incidence of early relapses and that, finally, inv(16) might be the only 'favourable' cytogenetic rearrangement in AML. Furthermore, the prognosis associated with t(9;11) or its variants (at least in adults), and trisomy 8 might be less severe than suggested in other studies.

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Cytogenetics and their prognostic value in de novo acute myeloid leukaemia: a report on 283 cases

Fenaux¹,

Preudhomme²,

Laı̈

et al. 1989

Br J Haematol

180

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Acute myelogenous leukaemia in children

Lie

1989

Eur J Pediatr

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Acute myelogenous leukaemia in childhood is considerably more resistant to chemotherapy than the acute lymphocytic leukaemias. Recently, more aggressive therapy has improved the outlook for children with this difficult form of leukaemia. Long-term disease-free survival of children achieving remission has been reported to be more than 40% in some studies. This paper reviews both the present concept of leukaemogenesis as well as some of the more recent therapeutic studies on childhood AML.

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Treatment strategies in acute myeloid leukemia (AML)

Hiddemann

Büchner

1990

Blut

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The strategy for treatment of relapsed or refractory acute myeloid leukemia must primarily be based on the patient's age and clinical condition as well as on the stage of the disease. Accordingly, the general decision between an intensive approach including high-dose chemotherapy or possibly immediate allogeneic bone marrow transplantation versus less-aggressive palliative treatment will precede the selection of the most appropriate salvage regimen. In patients qualifying for intensive second-line chemotherapy the duration of the first remission and the number of relapses provide the means to discriminate between refractoriness or maintained responsiveness to conventional protocols. More than 50% of patients with first relapses after 6-12 months remission duration will respond to standard therapy again and should therefore not be entered on investigational agents with unproven antileukemic activity. The latter seems deeply warranted, on the other hand, for early relapses, second recurrences and resistant first relapses with a remission rate of less than 30% after conventional regimens. These guidelines not only provide an objective rationale for selecting the most appropriate strategy at relapse in individual patients. Furthermore, they facilitate interstudy comparisons and a better judgement of different treatment protocols.

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Prognostic Significance of Chromosome Analysis in De Novo Acute Myeloid Leukemia

Cited by 14 publications

References 41 publications

Cytogenetics and their prognostic value in de novo acute myeloid leukaemia: a report on 283 cases

Cytogenetics and their prognostic value in de novo acute myeloid leukaemia: a report on 283 cases

Acute myelogenous leukaemia in children

Treatment strategies in acute myeloid leukemia (AML)

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