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
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- Published online on: November 1, 2002 https://doi.org/10.3892/ijo.21.5.1041
- Pages: 1041-1051
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Abstract
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.