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

Yiming Chen, Jorge Cortes, Zeev Estrov, Stefan Faderl, Wei Qiao, Lynne Abruzzo, Guillermo Garcia-Manero, Sherry Pierce, Xuelin Huang, Partow Kebriaei, Tapan Kadia, Marcos De Lima, Hagop Kantarjian, Farhad Ravandi

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44 Scopus citations

Abstract

Purpose: 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. Patients and Methods: Data from 254 adult patients with AML (excluding acute promyelocytic leukemia) who achieved CR after induction chemotherapy on various first-line protocols were examined. Results: 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)2507-2513
Number of pages7
JournalJournal of Clinical Oncology
Volume29
Issue number18
DOIs
StatePublished - Jun 20 2011
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Chen, Y., Cortes, J., Estrov, Z., Faderl, S., Qiao, W., Abruzzo, L., Garcia-Manero, G., Pierce, S., Huang, X., Kebriaei, P., Kadia, T., De Lima, M., Kantarjian, H., & Ravandi, F. (2011). 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. Journal of Clinical Oncology, 29(18), 2507-2513. https://doi.org/10.1200/JCO.2010.34.2873