The clinical significance of karyotype in acute myelogenous leukemia

Arthur, Diane C.; Berger, Roland; Golomb, Harvey M.; Swansbury, G. J.; Reeves, Brian; Alimena, Giuliana; Berghe, Herman Van den; Cd, Bloomfield; Chapelle, Albert de la; Dewald, GW; Garson, O. Margaret; Hagemeijer, A.; Kaneko, Yasuhiko; Mitelman, Felix; Pierre, Robert V.; Ruutu, Tapani; Sakurai, Masaharu; Lawler, Sylvia D.; Rowley, Janet D.

doi:10.1016/0165-4608(89)90025-3

Cited by 154 publications

(72 citation statements)

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“…If anything, our data support a favorable influence of t (15;17) reported in adult studies in the pre-ATRA era. 8,23 Our findings appear similar to the LAME group, which found that patients with t(15;17) and t(8;21) were similar in outcome to other pediatric patients with AML. 24 We also were unable to confirm the favorable influence of trisomy chromosome 8 on induction success which we had seen in our earlier study, CCG 251.…”

Section: Discussionsupporting

confidence: 78%

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

et al. 2002

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The objective of this study was to identify biologic parameters that were associated with either exceptionally good or poor outcome in childhood acute myeloid leukemia (AML). Among the children with AML who entered Children's Cancer Group trial 213, 498 patients without Down syndrome or acute promyelocytic leukemia (APL) comprise the basis for this report. Univariate comparisons of the proportion of patients attaining complete remission after induction (CR) indicate that, at diagnosis, male gender, low platelet count (р20 000/ l), hepatomegaly, myelodysplastic syndrome (MDS), French-AmericanBritish (FAB) category M5, high (Ͼ15%) bone marrow (BM) blasts on day 14 of the first course of induction, and +8 are associated with lower CR rates, while abnormal 16 is associated with a higher CR rate. Multivariate analysis suggests high platelet count at diagnosis (Ͼ20 000/ l), absence of hepatomegaly, р15% day 14 BM blast percentage, and abnormal 16 are independent prognostic factors associated with better CR. Univariate analysis demonstrated a significant favorable relationship between platelet count at diagnosis (Ͼ20 000/ l), absence of hepatomegaly, low percentage of BM blasts (р15%), and abnormal 16 with overall survival. Absence of hepatomegaly, р15% day 14 BM blast percentage, and abnormal 16 were determined to be independent prognostic factors associated with better survival. Leukemia (2002) 16, 601-607.

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Section: Discussionsupporting

confidence: 78%

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

et al. 2002

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“…[1][2][3][4][5] This has opened the possibility to select therapy according to the biological risk profile.…”

Section: Introductionmentioning

confidence: 99%

Risk-adapted postremission therapy in acute myeloid leukemia: results of the german multicenter AML HD93 treatment trial

Schlenk

Benner

Hartmann³

et al. 2003

Leukemia

106

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The objective of the AML HD93 treatment trial was to evaluate the outcome in young adults with acute myeloid leukemia (AML) after postremission therapy was stratified according to cytogenetically defined risk. The rationales for the study design were based (i) on previous favorable results with high-dose cytarabine in AML with t(8;21), inv/t(16q22) and in AML with normal karyotype, and ii) on encouraging results obtained in several phase II trials using autologous stem cell transplantation (SCT). Between July 1993 and January 1998, 223 eligible patients, 16-60 years of age with newly diagnosed AML other than French-American-British type M3/M3v, were entered into the trial. Risk groups were defined as follows: low risk: t(8;21) or inv/t(16q22); intermediate risk: normal karyotype; high risk: all other chromosomal abnormalities. Following intensive double induction therapy with idarubicin, cytarabine and etoposide, all patients in complete remission (CR) received a first consolidation therapy with high-dose cytarabine and mitoxantrone (HAM). A second consolidation therapy was stratified according to the risk group: low risk: HAM; intermediate risk: related allogeneic SCT or sequential HAM; high risk: related allogeneic or autologous SCT. Double induction therapy resulted in a high CR rate of 74.5%, and 90% of the responding patients were eligible for consolidation therapy. Survival for all 223 trial entrants was 40%, and for the 166 patients who entered CR, disease-free (DFS) and overall survival were 40 and 51% after 5 years, respectively. Within the low-, intermediate-and high-risk groups, DFS and survival after 5 years were 62.5 and 87, 40 and 49 and 17 and 26% respectively, without advantage for allogeneic transplantation in the intermediate-and high-risk groups. Postremission therapy-related mortality was 0, 7 and 14%, respectively. This study demonstrates the feasibility of cytogenetically defined risk-adapted consolidation therapy. The overall trial results are at least equivalent to those of published trials supporting the risk-adapted treatment strategy.

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“…[1][2][3][4] Several pretreatment factors such as age, performance status, leucocyte count and karyotype predict the outcome, but karyotype is certainly the most important prognostic factor for the rate of complete remission (CR), overall survival (OS) and disease-free survival (DFS). [5][6][7][8][9][10][11][12] Four large studies (and several smaller ones) demonstrated that the estimated OS at 5 years is around 35-65% among patients with favourable cytogenetics, while it is between 15 and 40% among patients with intermediate and below 20% among patients with adverse cytogenetics. [13][14][15][16] The prognosis of patients after a first relapse of AML is generally poor.…”

Section: Introductionmentioning

confidence: 99%

Impact of cytogenetics on the prognosis of adults with de novo AML in first relapse

Weltermann

Fonatsch²,

Haas

et al. 2003

Leukemia

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Karyotype is an important prognostic factor in patients with newly diagnosed acute myeloblastic leukaemia (AML). The prognostic value of cytogenetics on the outcome of patients with AML in relapse has not yet been well defined. We analysed the clinical outcome of 152 patients with de novo, chemotherapy-treated AML in first relapse according to the cytogenetic classification of the United Kingdom Medical Research Council. The rate of second complete remission (CR) (88, 64 and 36%) and the probability of survival at 3 years (43, 18 and 0%) were significantly different between the favourable, intermediate and adverse cytogenetic risk groups, respectively. Compared to the favourable group, the relative risk (RR) of death (multivariate analyses) was 2.6 (confidence interval (CI): 1.5-4.4, Po0.001) for the intermediate and 3.7 (CI: 1.7-7.9, P ¼ 0.001) for the adverse group. The prognostic value of the duration of first CR was confirmed (RR of death: 2.0 (CI: 1.0-4.0) for each additional year in first CR), whereas the FLT3 mutation obtained at diagnosis did not markedly influence the outcome of patients with AML in relapse. In conclusion, our results indicate that both karyotype and the duration of first CR are independent prognostic factors for patients with de novo AML in first relapse.

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The clinical significance of karyotype in acute myelogenous leukemia

Cited by 154 publications

References 2 publications

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

Risk-adapted postremission therapy in acute myeloid leukemia: results of the german multicenter AML HD93 treatment trial

Impact of cytogenetics on the prognosis of adults with de novo AML in first relapse

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