Identification of a group of AML/MDS patients with a relatively favorable prognosis who have chromosome 5 and/or 7 abnormalities.
OBJECTIVE
Patients with AML, RAEB-t, or RAEB and abnormalities involving chromosomes 5 and/or 7 (-5, -7) generally, but not always, have poorer prognoses than patients with a normal karyotype. Our objective was to see whether the occasional relatively favorable outcome in -5/-7 patients is a random event or, rather, reflects true heterogeneity in -5/-7.


METHODS
We examined 3 factors known to be prognostic in AML for their prognostic significance in 400 -5/-7 patients treated at the M.D. Anderson Cancer Center from 1980-1998 for AML or MDS. The outcome of comparative interest was survival as assessed by log-rank test.


RESULTS
There was evidence that outcome was better in -5/-7 patients with a simple (rather than complex) karyotype, with > 1 normal metaphase (rather than only metaphases containing -5/-7), and without an antecedent hematologic disorder. More importantly, the 10% of the patients with a simple karyotype, > 1 normal metaphase, and no antecedent hematologic disorder not only had a better outcome than the other -5/-7 patients but had essentially identical outcomes to the 669 AML/MDS patients with a normal karyotype treated at M.D. Anderson during the same period.


CONCLUSIONS
The results indicate that the -5/-7 group should not a priori be regarded as having an unfavorable prognosis, and more generally suggest the need to refine prognosis within each of the cytogenetic subsets of AML.
Estey
E H
EH
Department of Leukemia, Box 61, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030, USA. eeskky@odin.mdacc.tmc.edu
Pierce
S
S
Keating
M J
MJ
D000208:Acute Disease; D002869:Chromosome Aberrations / Q000097:blood*; D025063:Chromosome Disorders; D002895:Chromosomes, Human, Pair 5; D002897:Chromosomes, Human, Pair 7; D003582:Cytogenetics; D018572:Disease-Free Survival; D006801:Humans; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality; D008677:Metaphase / Q000235:genetics; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate