Chromosomes and causation of human cancer and leukemia. IL. Therapeutic and prognostic value of chromosomal findings during acute phase in Ph1-positive chronic myeloid leukemia.
The therapeutic response and survival after the onset of the acute crisis in 64 patients with Ph1-positive chronic myeloid leukemia (CML) were correlated with the chromosomal findings during the course of the acute phase. The patients were divided into three groups on the basis of the chromosome findings in the bone marrow, blood, and spleen: i.e. those with only a Ph1 (PP), those having two types of clones, i.e. one clone with only a Ph1 and another with additional karyotypic changes (AP), and those with only abnormal clones containing karyotypic abnormalities in addition to the Ph1 (AA). The number of patients in each group was: 22 in PP, 25 in AP and 17 in AA. The results were as follows: (1) The percentage of patients with a good therapeutic response was 77 per cent (17/22) in PP, 60 per cent (15/25) in AP and 29 per cent (5/17) in AA and 2). The median survival after the onset of the acute crisis was 148 days (4.9 months) in PP, 183 days (6.1 months) in AP and 53 days (1.8 months) in AA. Statistically, there was a significant difference between the AA and the other two groups (P less than 0.001). Our observations suggest that the lack of a clone with only a Ph1 during the course of the acute phase (AA) indicates an unfavourable response and a poor prognosis after the onset of the acute crisis in CML.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D002869:Chromosome Aberrations / Q000145:classification / Q000235:genetics* / Q000628:therapy; D025063:Chromosome Disorders; D002904:Chromosomes, Human, 21-22 and Y; D005260:Female; D006801:Humans; D007621:Karyotyping; D007938:Leukemia / Q000235:genetics / Q000628:therapy; D007951:Leukemia, Myeloid / Q000145:classification / Q000235:genetics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis