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Therapy-Related AML (t-AML)

Karyotype is an independent prognostic parameter in therapy-related acute myeloid leukemia (t-AML): an analysis of 93 patients with t-AML in comparison to 1091 patients with de novo AML

Leukemia volume 18, pages 120–125 (2004)Cite this article

Abstract

The aim of this study was to compare the pattern of karyotype abnormalities of therapy-related acute myeloid leukemia (t-AML) (n=93) with de novo AML (n=1091), and to evaluate their impact on prognosis. Favorable, intermediate, and unfavorable cytogenetics were observed in 25.8, 28.0, and 46.2% of t-AML, and in 22.2, 57.3, and 20.4% of de novo AML. The median overall survival (OS) was shorter in t-AML than in de novo AML (10 vs 15 months, P=0.0007). Favorable and unfavorable cytogenetics had a prognostic impact with respect to OS in both t-AML (P=0.001 and 0.0001) and de novo AML (P<0.0001 and <0.0001). To define the overall prognostic impact of cytogenetics and t-AML, a multivariate Cox's regression analysis was performed for OS with favorable cytogenetics, unfavorable cytogenetics, t-AML, age, and white blood cell (WBC) count as covariates. All parameters proved to be independently related to OS (P=0.001 for t-AML, P<0.0001 for all other parameters). Within patients with t-AML, there were significant correlations between OS and both unfavorable (P<0.0001) and favorable cytogenetics (P=0.001), while age and WBC count had no impact on OS. In conclusion, these data indicate that cytogenetics are an important prognostic parameter in t-AML. Furthermore, t-AML is an unfavorable factor independent of cytogenetics with respect to survival.

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Acknowledgements

The cell samples included in this study were sent for central diagnostics from various hospitals in Germany participating in the AMLCG trials (coordinators: T Büchner and W Berdel, Münster; W Hiddemann, München; B Wörmann, Braunschweig, Germany; statisticians: A Heinecke, MC Sauerland, Münster, Germany). We thank the coordinators and the statisticians of this study for their continuous support, as well as all clinicians for providing cell samples and clinical data.

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  1. Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany

    C Schoch, W Kern, S Schnittger, W Hiddemann & T Haferlach

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Schoch, C., Kern, W., Schnittger, S. et al. Karyotype is an independent prognostic parameter in therapy-related acute myeloid leukemia (t-AML): an analysis of 93 patients with t-AML in comparison to 1091 patients with de novo AML. Leukemia 18, 120–125 (2004). https://doi.org/10.1038/sj.leu.2403187

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