title: Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: a Center for International Blood and Marrow Transplant Research study.
abstract: Cytogenetics play a major role in determining the prognosis of patients with acute myelogenous leukemia (AML). However, existing cytogenetics classifications were developed in chemotherapy-treated patients and might not be optimal for patients undergoing allogeneic hematopoietic cell transplantation (HCT). We studied 821 adult patients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) who underwent HCT for AML in first or second complete remission between 1999 and 2004. We compared the ability of the 6 existing classifications to stratify patients by overall survival. We then defined a new scheme specifically applicable to patients undergoing HCT using this patient cohort. Under this scheme, inv(16) is favorable, a complex karyotype (4 or more abnormalities) is adverse, and all other classified abnormalities are intermediate in predicting survival after HCT (5-year overall survival, 64%, 18%, and 50%, respectively; P = .0001). This scheme stratifies patients into 3 groups with similar nonrelapse mortality, but significantly different incidences of relapse, overall and leukemia-free survival. It applies to patients regardless of disease status (first or second complete remission), donor type (matched related or unrelated), or conditioning intensity (myeloablative or reduced intensity). This transplantation-specific classification could be adopted for prognostication purposes and to stratify patients with AML and karyotypic abnormalities entering HCT clinical trials.
authors.affiliation: Dept of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Armand
authors.forename: Haesook T
authors.initials: HT
authors.lastname: Kim
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Waleska S
authors.initials: WS
authors.lastname: Perez
authors.forename: Paola S
authors.initials: PS
authors.lastname: Dal Cin
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Klumpp
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.forename: Jane L
authors.initials: JL
authors.lastname: Liesveld
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
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authors.lastname: Artz
authors.forename: Vikas
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authors.lastname: Gupta
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: Jean-Yves
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authors.lastname: Cahn
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.forename: Jürgen
authors.initials: J
authors.lastname: Finke
authors.forename: Edward D
authors.initials: ED
authors.lastname: Ball
authors.forename: Mahmoud D
authors.initials: MD
authors.lastname: Aljurf
authors.forename: Corey S
authors.initials: CS
authors.lastname: Cutler
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Rowe
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Antin
authors.forename: Luis M
authors.initials: LM
authors.lastname: Isola
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Bartolomeo
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Camitta
authors.forename: Alan M
authors.initials: AM
authors.lastname: Miller
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.forename: Keith
authors.initials: K
authors.lastname: Stockerl-Goldstein
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.forename: M Lynn
authors.initials: ML
authors.lastname: Savoie
authors.forename: Joerg
authors.initials: J
authors.lastname: Halter
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Stiff
authors.forename: Chadi
authors.initials: C
authors.lastname: Nabhan
authors.forename: Ann A
authors.initials: AA
authors.lastname: Jakubowski
authors.forename: Donald W
authors.initials: DW
authors.lastname: Bunjes
authors.forename: Effie W
authors.initials: EW
authors.lastname: Petersdorf
authors.forename: Steven M
authors.initials: SM
authors.lastname: Devine
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhauser
authors.forename: Victor A
authors.initials: VA
authors.lastname: Lewis
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Bredeson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Soiffer
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
mesh_terms: D059786:Abnormal Karyotype / Q000145:classification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007621:Karyotyping / Q000379:methods; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous