Independent prognostic significance of day 21 cytogenetic findings in newly-diagnosed acute myeloid leukemia or refractory anemia with excess blasts.
OBJECTIVE
We investigated whether cytogenetic findings (CG) on day 21 (D21) of the first course of chemotherapy predicted subsequent outcome in patients who presented with CG abnormalities.


METHODS
D21 CG analysis was performed in 197 patients.


RESULTS
Nineteen percent of the patients had exclusively abnormal metaphases (AA), 31% had only normal metaphases (NN), 39% had normal and abnormal metaphases (AN), and 11% had insufficient metaphases (0/0) on D21. A complete response was achieved in 79% of patients with NN, 60% with AN, 27% of those with AA, and 32% of those with 0/0.


CONCLUSIONS
Disease-free survival in CR was longest in patients who had > or =1 normal metaphase on D21, with this finding being independent of D21 marrow and initial CG results. D21 CG can be used in therapeutic decision-making.
Konopleva
Marina
M
Department of Blood and Marrow Transplantation, Section of Molecular Hematology and Therapy, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Cheng
Su-Chun
SC
Cortes
Jorge E
JE
Hayes
Kimberly J
KJ
Pierce
Sherry A
SA
Andreeff
Michael
M
Giles
Francis J
FJ
O'Brien
Susan
S
Kantarjian
Hagop M
HM
Estey
Elihu H
EH
D000208:Acute Disease; D000753:Anemia, Refractory / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008677:Metaphase; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome