Persistence of Cytogenetic Abnormalities at Complete Remission After Induction in Patients With Acute Myeloid Leukemia: Prognostic Significance and the Potential Role of Allogeneic Stem-Cell Transplantation

DOI Web Site 被引用文献1件
  • Yiming Chen
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Jorge Cortes
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Zeev Estrov
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Stefan Faderl
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Wei Qiao
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Lynne Abruzzo
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Guillermo Garcia-Manero
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Sherry Pierce
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Xuelin Huang
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Partow Kebriaei
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Tapan Kadia
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Marcos De Lima
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Hagop Kantarjian
    From the University of Texas MD Anderson Cancer Center, Houston, TX.
  • Farhad Ravandi
    From the University of Texas MD Anderson Cancer Center, Houston, TX.

説明

<jats:sec><jats:title>Purpose</jats:title><jats:p> To determine the prognostic impact of persistent cytogenetic abnormalities at complete remission (CR) on relapse-free survival (RFS) and overall survival (OS) in patients with acute myeloid leukemia (AML) and to examine the potential role of allogeneic stem-cell transplantation (SCT) in this setting. </jats:p></jats:sec><jats:sec><jats:title>Patients and Methods</jats:title><jats:p> Data from 254 adult patients with AML (excluding acute promyelocytic leukemia) who achieved CR after induction chemotherapy on various first-line protocols were examined. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Median follow-up for surviving patients was 43 months. Patients with cytogenetic abnormalities at CR (n = 71) had significantly shorter RFS (P = .001) and OS (P < .001) compared with patients with normal cytogenetics at CR (n = 183); 3-year RFS was 15% and 45%, and 3-year OS was 15% and 56%, respectively. Among the patients with persistent cytogenetic abnormalities at CR, those who underwent SCT in first CR (CR1; n = 15) had better RFS and OS compared to those without SCT (n = 56; P = .04 and .06, respectively). In multivariate analysis, persistent cytogenetic abnormalities at CR was an independent predictor for RFS (P < .001) and OS (P = .001), but among patients with persistent cytogenetic abnormalities at CR, no significant differences in OS (P = .25) was observed between those who did or did not receive SCT with a trend favoring SCT for RFS (P = .08). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Persistent cytogenetically abnormal cells at CR predict a significantly shorter RFS and OS. SCT in CR1 may improve the clinical outcome of patients lacking cytogenetic remission after induction although this depends on patient selection. </jats:p></jats:sec>

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