title: Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia.
abstract: BACKGROUND
  Trisomy 21 is frequently noted in patients with AML. In adults, +21 has traditionally been considered an intermediate-risk cytogenetic aberration.
  
  
  METHODS
  We analyzed 90 patients with newly diagnosed AML harboring +21. Four cytogenetic subgroups were defined based on associated cytogenetic abnormalities: +21 alone, +21 with favorable, +21 with intermediate, and +21 with unfavorable cytogenetics.
  
  
  RESULTS
  Fifty-four percent of patients with +21 AML achieved a complete remission (CR) or CR with incomplete platelet recovery (CRp) after induction therapy with a trend toward improved CR/CRp rates in patients with +21 alone/+21 with favorable cytogenetics compared with patients with +21 with intermediate/+21 with unfavorable cytogenetics (76% vs. 50%; P = .057). Time to progression (TTP) was 12 months (range, 5-19) and overall survival (OS) was 9 months (range, 7-11) for the entire group. TTP was longer for patients with +21 alone (not reached) or with +21 with favorable cytogenetics (101 months) compared with those with +21 with intermediate cytogenetics (2 months) or +21 with unfavorable cytogenetics (11 months) (P = .02). Similarly, OS was improved in patients with +21 with favorable cytogenetics (not reached) or +21 alone (107 months), compared with +21 with unfavorable cytogenetics (9 months) or +21 with intermediate cytogenetics (8 months) (P < .001). The differences in TTP and OS were maintained on multivariate analysis (P = .04 and P = .001; respectively).
  
  
  CONCLUSIONS
  Isolated +21 hitherto classified as intermediate-risk cytogenetics might actually behave as a favorable-risk cytogenetics in adult AML patients.
authors: Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, TX.
authors: Paolo
authors: P
authors: Strati
authors: Naval
authors: N
authors: Daver
authors: Farhad
authors: F
authors: Ravandi
authors: Naveen
authors: N
authors: Pemmaraju
authors: Sherry
authors: S
authors: Pierce
authors: Guillermo
authors: G
authors: Garcia-Manero
authors: Aziz
authors: A
authors: Nazha
authors: Tapan
authors: T
authors: Kadia
authors: Elias
authors: E
authors: Jabbour
authors: Gautam
authors: G
authors: Borthakur
authors: Stefan
authors: S
authors: Faderl
authors: Alfonso
authors: A
authors: Quintas-Cardama
authors: Hagop
authors: H
authors: Kantarjian
authors: Jorge
authors: J
authors: Cortes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003582:Cytogenetics; D018572:Disease-Free Survival; D004314:Down Syndrome / Q000235:genetics / Q000473:pathology*; D005260:Female; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
keywords: AML; Cytogenetic; Down syndrome; Prognosis; trisomy 21
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