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Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: a Center for International Blood and Marrow Transplant Research study.


ABSTRACT: Cytogenetics play a major role in determining the prognosis of patients with acute myelogenous leukemia (AML). However, existing cytogenetics classifications were developed in chemotherapy-treated patients and might not be optimal for patients undergoing allogeneic hematopoietic cell transplantation (HCT). We studied 821 adult patients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) who underwent HCT for AML in first or second complete remission between 1999 and 2004. We compared the ability of the 6 existing classifications to stratify patients by overall survival. We then defined a new scheme specifically applicable to patients undergoing HCT using this patient cohort. Under this scheme, inv(16) is favorable, a complex karyotype (4 or more abnormalities) is adverse, and all other classified abnormalities are intermediate in predicting survival after HCT (5-year overall survival, 64%, 18%, and 50%, respectively; P = .0001). This scheme stratifies patients into 3 groups with similar nonrelapse mortality, but significantly different incidences of relapse, overall and leukemia-free survival. It applies to patients regardless of disease status (first or second complete remission), donor type (matched related or unrelated), or conditioning intensity (myeloablative or reduced intensity). This transplantation-specific classification could be adopted for prognostication purposes and to stratify patients with AML and karyotypic abnormalities entering HCT clinical trials.

SUBMITTER: Armand P 

PROVIDER: S-EPMC3224672 | biostudies-literature | 2012 Feb

REPOSITORIES: biostudies-literature

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Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: a Center for International Blood and Marrow Transplant Research study.

Armand Philippe P   Kim Haesook T HT   Zhang Mei-Jie MJ   Perez Waleska S WS   Dal Cin Paola S PS   Klumpp Thomas R TR   Waller Edmund K EK   Litzow Mark R MR   Liesveld Jane L JL   Lazarus Hillard M HM   Artz Andrew S AS   Gupta Vikas V   Savani Bipin N BN   McCarthy Philip L PL   Cahn Jean-Yves JY   Schouten Harry C HC   Finke Jürgen J   Ball Edward D ED   Aljurf Mahmoud D MD   Cutler Corey S CS   Rowe Jacob M JM   Antin Joseph H JH   Isola Luis M LM   Di Bartolomeo Paolo P   Camitta Bruce M BM   Miller Alan M AM   Cairo Mitchell S MS   Stockerl-Goldstein Keith K   Sierra Jorge J   Savoie M Lynn ML   Halter Joerg J   Stiff Patrick J PJ   Nabhan Chadi C   Jakubowski Ann A AA   Bunjes Donald W DW   Petersdorf Effie W EW   Devine Steven M SM   Maziarz Richard T RT   Bornhauser Martin M   Lewis Victor A VA   Marks David I DI   Bredeson Christopher N CN   Soiffer Robert J RJ   Weisdorf Daniel J DJ  

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 20110731 2


Cytogenetics play a major role in determining the prognosis of patients with acute myelogenous leukemia (AML). However, existing cytogenetics classifications were developed in chemotherapy-treated patients and might not be optimal for patients undergoing allogeneic hematopoietic cell transplantation (HCT). We studied 821 adult patients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) who underwent HCT for AML in first or second complete remission between 199  ...[more]

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