Karyotype abnormalities and their clinical significance in a group of chronic myeloid leukemia patients treated with hematopoietic stem cell transplantation.
OBJECTIVE
Following hematopoietic stem cell transplantation (HSCT), karyotyping is a valuable tool for monitoring engraftment and disease status. Few studies have examined the prognostic significance of karyotypes in patients who underwent HSCT for chronic myeloid leukemia (CML). The objective of this study was to evaluate the significance of pretransplantation cytogenetic status in relation to outcomes following HSCT in CML patients.


METHODS
Case series study at Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil.


METHODS
Cytogenetic analysis was performed by G banding on 39 patients treated with HSCT.


RESULTS
Thirty-one patients were in the chronic phase and eight were in the accelerated phase. Prior to HSCT, additional chromosomal abnormalities on the Philadelphia (Ph) chromosome were found in 11 patients. The most frequent additional abnormality was a double Ph, which was observed in four cases. Following HSCT, full chimeras were observed in 31 patients (79.5%). Among these, 23 (82.3%) had presented Ph as the sole abnormality. Mixed chimeras were observed in seven patients, of which three had additional abnormalities. Only one case did not present any cytogenetic response. Five patients presented cytogenetic relapse associated with clinical relapse following HSCT. Twenty-seven patients are still alive and present complete hematological and cytogenetic remission.


CONCLUSIONS
In our study, the presence of additional abnormalities was not associated with worse outcome and relapse risk. Also, no differences in survival rates were observed. Our study supports the view that classical cytogenetic analysis remains an important tool regarding HSCT outcome.
Otero
Luize
L
Cytogenetic Laboratory, Bone Marrow Transplantation Center, Instituto Nacional do Câncer, Rio de Janeiro, Brazil. luizeotero@hotmail.com
Ornellas
Maria Helena
MH
de Azevedo
Alexandre Mello
AM
Tavares
Rita de Cássia
Rde C
Pires
Virgínia
V
Abdelhay
Eliana
E
Bouzas
Luis Fernando
LF
Fernandez
Teresa de Souza
Tde S
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002869:Chromosome Aberrations; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D011379:Prognosis; D016019:Survival Analysis; D019172:Transplantation Conditioning