Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia

Paolo Strati, Naval Daver, Farhad Ravandi, Naveen Pemmaraju, Sherry Pierce, Guillermo Garcia-Manero, Aziz Nazha, Tapan Kadia, Elias Jabbour, Gautam Borthakur, Stefan Faderl, Alfonso Quintas-Cardama, Hagop Kantarjian, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)S276-S281
JournalClinical Lymphoma, Myeloma and Leukemia
Volume13
Issue numberSUPPL. 2
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

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Down Syndrome
Acute Myeloid Leukemia
Cytogenetics
Chromosome Aberrations
Survival
Blood Platelets
Multivariate Analysis

Keywords

  • AML
  • Cytogenetic
  • Down syndrome
  • Prognosis
  • trisomy 21

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia. / Strati, Paolo; Daver, Naval; Ravandi, Farhad; Pemmaraju, Naveen; Pierce, Sherry; Garcia-Manero, Guillermo; Nazha, Aziz; Kadia, Tapan; Jabbour, Elias; Borthakur, Gautam; Faderl, Stefan; Quintas-Cardama, Alfonso; Kantarjian, Hagop; Cortes, Jorge.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 13, No. SUPPL. 2, 01.09.2013, p. S276-S281.

Research output: Contribution to journalArticle

Strati, P, Daver, N, Ravandi, F, Pemmaraju, N, Pierce, S, Garcia-Manero, G, Nazha, A, Kadia, T, Jabbour, E, Borthakur, G, Faderl, S, Quintas-Cardama, A, Kantarjian, H & Cortes, J 2013, 'Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia', Clinical Lymphoma, Myeloma and Leukemia, vol. 13, no. SUPPL. 2, pp. S276-S281. https://doi.org/10.1016/j.clml.2013.05.020
Strati, Paolo ; Daver, Naval ; Ravandi, Farhad ; Pemmaraju, Naveen ; Pierce, Sherry ; Garcia-Manero, Guillermo ; Nazha, Aziz ; Kadia, Tapan ; Jabbour, Elias ; Borthakur, Gautam ; Faderl, Stefan ; Quintas-Cardama, Alfonso ; Kantarjian, Hagop ; Cortes, Jorge. / Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia. In: Clinical Lymphoma, Myeloma and Leukemia. 2013 ; Vol. 13, No. SUPPL. 2. pp. S276-S281.
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abstract = "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.",
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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 - 2013/9/1

Y1 - 2013/9/1

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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