Complex karyotypes confer a poor survival in adult acute myeloid leukemia with unfavorable cytogenetic abnormalities

Chih Cheng Chen, Ching Fen Yang, Kuan Der Lee, Jie Yu You, Yuan Bin Yu, Chao Hung Ho, Cheng Hwai Tzeng, Wing Keung Chau, Hui Chi Hsu, Jyh Pyng Gau

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Abstract

Cytogenetics represents the most valuable predictor for a poor outcome in patients with acute myeloid leukemia (AML), but it encompasses a heterogeneous patient population who might have diverse pathogenesis and clinical courses. In particular, the significance of complex chromosome aberrations within this cohort has seldom been addressed before. We analyzed 48 AML patients with adverse-risk cytogenetics in this study. The complex karyotype (three or more numerical/structural cytogenetic changes; 29 patients) was found to occur more frequently among the elderly than a noncomplex adverse karyotype (19 patients; median age, 71 vs. 48; P = 0.005). The patients' performance status was the sole independent factor determining the complete remission rate among patients receiving standard induction chemotherapy. On survival analysis, two factors independently predicted a longer overall survival: noncomplex karyotypes [vs. complex karyotypes, hazard ratio (HR) 0.434, 95% confidence interval (CI) 0.189-0.994, P = 0.048] and achievement of complete remission [(CR) vs. CR not reached, HR 0.170, 95% CI 0.051-0.572, P = 0.004)]. In conclusion, among AML patients with adverse cytogenetics, complex chromosomal aberrations occurred more frequently among the elderly and predicted a poor outcome. These patients should be considered as a unique entity and be separated from those with a noncomplex adverse cytogenetic change. Exploring the underlying mechanisms of leukemogenesis could improve the therapeutic outcome for this group of patients.

Original languageEnglish
Pages (from-to)138-146
Number of pages9
JournalCancer Genetics and Cytogenetics
Volume174
Issue number2
DOIs
Publication statusPublished - Apr 15 2007
Externally publishedYes

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Karyotype
Acute Myeloid Leukemia
Chromosome Aberrations
Survival
Cytogenetics
Confidence Intervals
Induction Chemotherapy
Survival Analysis

ASJC Scopus subject areas

  • Cancer Research
  • Genetics
  • Molecular Biology

Cite this

Complex karyotypes confer a poor survival in adult acute myeloid leukemia with unfavorable cytogenetic abnormalities. / Chen, Chih Cheng; Yang, Ching Fen; Lee, Kuan Der; You, Jie Yu; Yu, Yuan Bin; Ho, Chao Hung; Tzeng, Cheng Hwai; Chau, Wing Keung; Hsu, Hui Chi; Gau, Jyh Pyng.

In: Cancer Genetics and Cytogenetics, Vol. 174, No. 2, 15.04.2007, p. 138-146.

Research output: Contribution to journalArticle

Chen, Chih Cheng ; Yang, Ching Fen ; Lee, Kuan Der ; You, Jie Yu ; Yu, Yuan Bin ; Ho, Chao Hung ; Tzeng, Cheng Hwai ; Chau, Wing Keung ; Hsu, Hui Chi ; Gau, Jyh Pyng. / Complex karyotypes confer a poor survival in adult acute myeloid leukemia with unfavorable cytogenetic abnormalities. In: Cancer Genetics and Cytogenetics. 2007 ; Vol. 174, No. 2. pp. 138-146.
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abstract = "Cytogenetics represents the most valuable predictor for a poor outcome in patients with acute myeloid leukemia (AML), but it encompasses a heterogeneous patient population who might have diverse pathogenesis and clinical courses. In particular, the significance of complex chromosome aberrations within this cohort has seldom been addressed before. We analyzed 48 AML patients with adverse-risk cytogenetics in this study. The complex karyotype (three or more numerical/structural cytogenetic changes; 29 patients) was found to occur more frequently among the elderly than a noncomplex adverse karyotype (19 patients; median age, 71 vs. 48; P = 0.005). The patients' performance status was the sole independent factor determining the complete remission rate among patients receiving standard induction chemotherapy. On survival analysis, two factors independently predicted a longer overall survival: noncomplex karyotypes [vs. complex karyotypes, hazard ratio (HR) 0.434, 95{\%} confidence interval (CI) 0.189-0.994, P = 0.048] and achievement of complete remission [(CR) vs. CR not reached, HR 0.170, 95{\%} CI 0.051-0.572, P = 0.004)]. In conclusion, among AML patients with adverse cytogenetics, complex chromosomal aberrations occurred more frequently among the elderly and predicted a poor outcome. These patients should be considered as a unique entity and be separated from those with a noncomplex adverse cytogenetic change. Exploring the underlying mechanisms of leukemogenesis could improve the therapeutic outcome for this group of patients.",
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