TY - JOUR
T1 - Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia
AU - Strati, Paolo
AU - Daver, Naval
AU - Ravandi, Farhad
AU - Pemmaraju, Naveen
AU - Pierce, Sherry
AU - Garcia-Manero, Guillermo
AU - Nazha, Aziz
AU - Kadia, Tapan
AU - Jabbour, Elias
AU - Borthakur, Gautam
AU - Faderl, Stefan
AU - Quintas-Cardama, Alfonso
AU - Kantarjian, Hagop
AU - Cortes, Jorge
PY - 2013/9
Y1 - 2013/9
N2 - Introduction Trisomy 21 is frequently noted in patients with AML. In adults, +21 has traditionally been considered an intermediate-risk cytogenetic aberration. Patients and Methods We analyzed 90 patients with newly diagnosed AML harboring +21. Four cytogenetic subgroups were defined based on associated cytogenetic abnormalities: +21 alone, +21 with favorable, +21 with intermediate, and +21 with unfavorable cytogenetics. Results Fifty-four percent of patients with +21 AML achieved a complete remission (CR) or CR with incomplete platelet recovery (CRp) after induction therapy with a trend toward improved CR/CRp rates in patients with +21 alone/+21 with favorable cytogenetics compared with patients with +21 with intermediate/+21 with unfavorable cytogenetics (76% vs. 50%; P =.057). Time to progression (TTP) was 12 months (range, 5-19) and overall survival (OS) was 9 months (range, 7-11) for the entire group. TTP was longer for patients with +21 alone (not reached) or with +21 with favorable cytogenetics (101 months) compared with those with +21 with intermediate cytogenetics (2 months) or +21 with unfavorable cytogenetics (11 months) (P =.02). Similarly, OS was improved in patients with +21 with favorable cytogenetics (not reached) or +21 alone (107 months), compared with +21 with unfavorable cytogenetics (9 months) or +21 with intermediate cytogenetics (8 months) (P <.001). The differences in TTP and OS were maintained on multivariate analysis (P =.04 and P =.001; respectively). Conclusion Isolated +21 hitherto classified as intermediate-risk cytogenetics might actually behave as a favorable-risk cytogenetics in adult AML patients.
AB - Introduction Trisomy 21 is frequently noted in patients with AML. In adults, +21 has traditionally been considered an intermediate-risk cytogenetic aberration. Patients and Methods We analyzed 90 patients with newly diagnosed AML harboring +21. Four cytogenetic subgroups were defined based on associated cytogenetic abnormalities: +21 alone, +21 with favorable, +21 with intermediate, and +21 with unfavorable cytogenetics. Results Fifty-four percent of patients with +21 AML achieved a complete remission (CR) or CR with incomplete platelet recovery (CRp) after induction therapy with a trend toward improved CR/CRp rates in patients with +21 alone/+21 with favorable cytogenetics compared with patients with +21 with intermediate/+21 with unfavorable cytogenetics (76% vs. 50%; P =.057). Time to progression (TTP) was 12 months (range, 5-19) and overall survival (OS) was 9 months (range, 7-11) for the entire group. TTP was longer for patients with +21 alone (not reached) or with +21 with favorable cytogenetics (101 months) compared with those with +21 with intermediate cytogenetics (2 months) or +21 with unfavorable cytogenetics (11 months) (P =.02). Similarly, OS was improved in patients with +21 with favorable cytogenetics (not reached) or +21 alone (107 months), compared with +21 with unfavorable cytogenetics (9 months) or +21 with intermediate cytogenetics (8 months) (P <.001). The differences in TTP and OS were maintained on multivariate analysis (P =.04 and P =.001; respectively). Conclusion Isolated +21 hitherto classified as intermediate-risk cytogenetics might actually behave as a favorable-risk cytogenetics in adult AML patients.
KW - AML
KW - Cytogenetic
KW - Down syndrome
KW - Prognosis
KW - trisomy 21
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U2 - 10.1016/j.clml.2013.05.020
DO - 10.1016/j.clml.2013.05.020
M3 - Article
C2 - 23969309
AN - SCOPUS:84889087733
SN - 2152-2650
VL - 13
SP - S276-S281
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - SUPPL. 2
ER -