Advanced age and high initial WBC influence the outcome of inv(3) (q21q26)/t(3;3) (q21;q26) positive AML.
AML with inv(3)/t(3;3) are generally considered of having a poor prognosis. For further insight in this rare entity the outcome of 65 inv(3)/t(3;3) positive AML cases were examined with special emphasis o n patient a nd disease related factors at diagnosis. Survival data were available from 35 patients. A hematological CR was achieved in 16/35 patients (46%). Eight patients (50%) relapsed. The median duration of remission was 177 days. Probability of OS was 23% at 2 years. Advanced age and high initial WBC count were associated with shorter OS (p = 0.021 and p = 0.005, respectively). Loss of chromosome 7 was the most frequent additional aberration (n = 34; 52%), followed complex aberrant aberrations (n = 5). Cases with monosomy 7 or the presence of FLT3-length mutations (FLT3-LM)--detected in 13% of cases--were not associated with an even more inferior outcome. Allogeneic stem cell translplantation, performed in 12 cases, resulted in a probability of OS of 62% at 2 years. Our data (1) confirm that inv(3)/t(3;3) AML has a poor prognosis (2) show that age and initial WBC are risk factors for prognosis; (3) suggest that this group may benefit from allogeneic stem cell transplantation.
Weisser
Martin
M
Medical Department III, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany. martin.weisser@gmx.de
Haferlach
Claudia
C
Haferlach
Torsten
T
Schnittger
Susanne
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000616:Aminoglutethimide / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D007446:Chromosome Inversion; D002893:Chromosomes, Human, Pair 3; D015331:Cohort Studies; D003561:Cytarabine / Q000627:therapeutic use; D003613:Danazol / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000627:therapeutic use; D011379:Prognosis; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use; D014178:Translocation, Genetic
D003561:Cytarabine; D013629:Tamoxifen; D000616:Aminoglutethimide; D008942:Mitoxantrone; D003613:Danazol