Additional chromosome abnormalities in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy
Por:
Cervera, J, Montesinos, P, Hernandez-Rivas, JM, Calasanz, MJ, Aventin, A, Ferro, MT, Luno, E, Sanchez, J, Vellenga, E, Rayon, C, Milone, G, de la Serna, J, Rivas, C, Gonzalez, JD, Tormo, M, Amutio, E, Gonzalez, M, Brunet, S, Lowenberg, B, Sanz, MA
Publicada:
1 mar 2010
Resumen:
Background
Acute promyelocytic leukemia is a subtype of acute myeloid leukemia characterized by the t(15;17). The incidence and prognostic significance of additional chromosomal abnormalities in acute promyelocytic leukemia is still a controversial matter.
Design and Methods
Based on cytogenetic data available for 495 patients with acute promyelocytic leukemia enrolled in two consecutive PETHEMA trials (LPA96 and LPA99), we analyzed the incidence, characteristics, and outcome of patients with acute promyelocytic leukemia with and without additional chromosomal abnormalities who had been treated with all-trans retinoic acid plus anthracycline monochemotherapy for induction and consolidation.
Results
Additional chromosomal abnormalities were observed in 140 patients (28%). Trisomy 8 was the most frequent abnormality (36%), followed by abn(7q) (5%). Patients with additional chromosomal abnormalities more frequently had coagulopathy (P=0.03), lower platelet counts (P=0.02), and higher relapse-risk scores (P=0.02) than their counterparts without additional abnormalities. No significant association with FLT3/ITD or other clinicopathological characteristics was demonstrated. Patients with and without additional chromosomal abnormalities had similar complete remission rates (90% and 91%, respectively). Univariate analysis showed that additional chromosomal abnormalities were associated with a lower relapse-free survival in the LPA99 trial (P=0.04), but not in the LPA96 trial. However, neither additional chromosomal abnormalities overall nor any specific abnormality was identified as an independent risk factor for relapse in multivariate analysis.
Conclusions
The lack of independent prognostic value of additional chromosomal abnormalities in acute promyelocytic leukemia does not support the use of alternative therapeutic strategies when such abnormalities are found.
Filiaciones:
Cervera, J:
Hosp Univ Fe, Valencia 46009, Spain
Montesinos, P:
Hosp Univ Fe, Valencia 46009, Spain
Hernandez-Rivas, JM:
Hosp Clin Univ, Salamanca, Spain
Calasanz, MJ:
Univ Navarra, E-31080 Pamplona, Spain
Aventin, A:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Ferro, MT:
Hosp Ramon & Cajal, E-28034 Madrid, Spain
Luno, E:
Univ Oviedo, Hosp Cent Asturias, E-33080 Oviedo, Spain
Sanchez, J:
Hosp Univ Virgen Rocio, Seville, Spain
Vellenga, E:
Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
Rayon, C:
Univ Oviedo, Hosp Cent Asturias, E-33080 Oviedo, Spain
Milone, G:
Fundaleu, Buenos Aires, DF, Argentina
de la Serna, J:
Hosp 12 Octubre, E-28041 Madrid, Spain
Rivas, C:
Hosp Gen Alicante, Alicante, Spain
Gonzalez, JD:
Hosp Insular, Las Palmas Gran Canaria, Spain
Tormo, M:
Hosp Clin Univ, Valencia, Spain
Amutio, E:
Hosp Cruces, Baracaldo, Spain
Gonzalez, M:
Hosp Clin Univ, Salamanca, Spain
Brunet, S:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Lowenberg, B:
Erasmus Univ, Med Ctr, Rotterdam, Netherlands
Sanz, MA:
Hosp Univ Fe, Valencia 46009, Spain
Gold, Green Published
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