title: Failure matters: unsuccessful cytogenetics and unperformed cytogenetics are associated with a poor prognosis in a population-based series of acute myeloid leukaemia.
abstract: Unsuccessful cytogenetics (UC) in patients with acute myeloid leukaemia (AML) treated on different SWOG trials was recently reported to be associated with increased age and dismal outcome. To ascertain whether this holds true also in unselected patients with AML, we retrieved all cytogenetic reports in cases from the population-based Swedish AML Registry. Between 1997 and 2006, 1737 patients below 80 yr of age without myelosarcoma or acute promyelocytic leukaemia received intensive treatment. The frequencies of UC and unperformed cytogenetics (UPC) were 2.1% and 20%, respectively. The early death rates differed between the cytogenetic subgroups (P = 0.006) with the highest rates in patients with UC (14%) and UPC (12%) followed by high-risk (HR) AML, intermediate risk (IR) and standard risk (SR) cases successfully karyotyped (8.6%, 5.9%, and 5.8%, respectively). The complete remission rate was lower in UC and UPC and HR compared with the other risk groups (P < 0.001). The overall five-year survival rates were 25% for UC and 22% for UPC, whereas the corresponding frequencies for SR, IR and HR AML patients without UC and UPC were 64%, 31% and 15%, respectively. In conclusion, lack of cytogenetic data translates into a poor prognosis.
authors.affiliation: Department of Hematology and Coagulation, Skåne University Hospital, Lund, Sweden; Stem Cell Center, Lund University, Lund, Sweden.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lazarevic
authors.forename: Ann-Sofi
authors.initials: AS
authors.lastname: Hörstedt
authors.forename: Bertil
authors.initials: B
authors.lastname: Johansson
authors.forename: Petar
authors.initials: P
authors.lastname: Antunovic
authors.forename: Rolf
authors.initials: R
authors.lastname: Billström
authors.forename: Åsa
authors.initials: Å
authors.lastname: Derolf
authors.forename: Sören
authors.initials: S
authors.lastname: Lehmann
authors.forename: Lars
authors.initials: L
authors.lastname: Möllgård
authors.forename: Stefan
authors.initials: S
authors.lastname: Peterson
authors.forename: Dick
authors.initials: D
authors.lastname: Stockelberg
authors.forename: Bertil
authors.initials: B
authors.lastname: Uggla
authors.forename: Lovisa
authors.initials: L
authors.lastname: Vennström
authors.forename: Anders
authors.initials: A
authors.lastname: Wahlin
authors.forename: Martin
authors.initials: M
authors.lastname: Höglund
authors.forename: Gunnar
authors.initials: G
authors.lastname: Juliusson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D007621:Karyotyping / Q000706:statistics & numerical data*; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D013548:Sweden
chemical_list: D000970:Antineoplastic Agents
keywords: acute myeloid leukaemia; karyotype; survival; unperformed cytogenetics; unsuccessful metaphase analysis