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Clinical Laboratory Correlates

Survival time in a population-based consecutive series of adult acute myeloid leukemia – the prognostic impact of karyotype during the time period 1976–1993

Leukemia volume 14, pages 1039–1043 (2000)Cite this article

Abstract

A consecutive population-based series of 372 adult acute myeloid leukemias, successfully cytogenetically investigated at a single center between 1976 and 1993, is reported. All medical records were reviewed in order to ascertain the prognostic impact of karyotype, divided into three groups; favorable (t(8;21), t(15;17), and inv(16) irrespective of karyotypic complexity; n= 40), poor (der(1;7), inv(3), −5, del(5q), −7, t(9;22), and complex karyotypes including whole or partial losses of chromosomes 5 and/or 7; n = 56), and intermediate (other abnormalities or normal karyotype; n = 276). The possible modification by age, gender, time period, morphologic subtype, and bone marrow transplantation (BMT) on this prognostic impact was also determined. The chemotherapy regimens used were heterogeneous over time but principally the same at any given point in time. The majority of the patients were treated with combinations including an anthracycline and cytarabine with curative intent. Gender, morphology, and BMT did not significantly modify the effect of cytogenetic patterns on survival time, whereas age and time period did. The hazard ratios for the subgroups favorable, intermediate, and poor were 1.0, 1.2 and 1.9 at age 20–49; 1.0, 2.5 and 4.5 at age 50–64; 1.0, 4.1 and 11.4 at age 65–74; 1.0, 1.4 and 2.2 for the time period 1976–1987 and 1.0, 2.0 and 6.7 for 1988–1993. The salient feature of the Kaplan–Meier curves was the improved survival during the later time period for patients with favorable and intermediate cytogenetic abnormalities. The present findings thus suggest that it is mainly these patient groups that have benefited from advances in therapy, including supportive care.

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Acknowledgements

This study was supported by grants from the Swedish Cancer Society, the Swedish Council for Work Life Research, PREEM Research Foundation, Georg Danielsson's Fund, John Persson's Foundation, Gunnar, Arvid and Elisabeth Nilsson's Foundation, and Lund University Hospital Funds.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology, Lund University Hospital, Lund, Sweden

    N Mauritzson, R Billström & PG Nilsson

  2. Department of Clinical Genetics, Lund University Hospital, Lund, Sweden

    B Johansson & F Mitelman

  3. Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden

    M Albin, L Rylander, Z Mikoczy, U Strömberg & L Hagmar

  4. Department of Hematology, Malmö University Hospital, Malmö, Sweden

    T Ahlgren

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Mauritzson, N., Johansson, B., Albin, M. et al. Survival time in a population-based consecutive series of adult acute myeloid leukemia – the prognostic impact of karyotype during the time period 1976–1993. Leukemia 14, 1039–1043 (2000). https://doi.org/10.1038/sj.leu.2401788

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