engleski

Prognostic significance of chromosome findings in de-novo acute myleogenous leukaemia

Problem: The incidence and prognostic significance of chromosome abnormalities in patients with de-novo acute myelogenous leukemia was evaluated. Methods: From 1987. until 1995. 110 patients with de novo acute leukemia were included into the study. The majority of patients have AML-M2 (41%) or AML- M1 subtype (23%). Patients with translocation t(8 ; 21), inversion inv (16), translocation t (15 ; 17) and trisomy 21 were considered as good prognostic group while patients with trisomy 8, and changes of chromosome 5, 7 and 11 were considered as poor prognostic group. All other patients wewincluded into intermediate group. Standard G banded karyotyping was done. In some cases additional FISH was implemented. Results: Normal karyotype was found in 31 (28%) patients while abnormal karyotype was found in 62% patients. Translocations t (8 ; 21), t (15 ; 17) and t (9 ; 11) were the most frequent findings (43% of all analyzed samples). Changes of chromosome 5 and 7 were documented in 19% of all patients. According to the cytogenetics thirty (27%) patients were classified as a good prognostic group, and 43 (39%) as a poor prognosis group. Thirty-seven (34%) were classified as an intermediate group. A significantly higher (p<0.05) comlete remission rate was obtained of patients with good karyotype (81%) compared to patients with intermediate karyotype 865%) and patients with poor prognostic group (37%). The DFS probability of patients with good, intermediate and poor karyotype was 40%, 30% and 5% respectively (P=0.05). The highest probability of relapse4 is observed in patients with poor karyotype (82%). The relapse rate for patients with intermediate karyotype was 68% and for patients with good karyotype 56% (p<0.03). In multivariate analysis patients with high number of WBC at diagnosis (RR=2.7, p<0.05) older age (RR=1.4, p<0.05) and poor karyotype (RR=2.4, p<0.04) have high probability of induction treatment failure than other patients. Conclusion: Cytogenetic abnormalities were found in 72% of patients. Patients with good or intermediate karyotype had higher remission rate and better disease free survival than patients with poor karyotype.

chromosome ; acute myelogenous leukemia ; prognostic significance

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