|
|
Blood, 1 July 2006, Vol. 108, No. 1, pp. 63-73.
Prepublished online as a Blood First Edition Paper on March 7, 2006; DOI 10.1182/blood-2005-11-4354.
 Previous Article | Table of Contents | Next Article 
CLINICAL TRIALS AND OBSERVATIONS
Pretreatment cytogenetics add to other prognostic factors predicting complete remission and long-term outcome in patients 60 years of age or older with acute myeloid leukemia: results from Cancer and Leukemia Group B 8461
Sherif S. Farag,
Kellie J. Archer,
Krzysztof Mrózek,
Amy S. Ruppert,
Andrew J. Carroll,
James W. Vardiman,
Mark J. Pettenati,
Maria R. Baer,
Mazin B. Qumsiyeh,
Prasad R. Koduru,
Yi Ning,
Robert J. Mayer,
Richard M. Stone,
Richard A. Larson, and
Clara D. Bloomfield
From The Ohio State University, Columbus, OH; Virginia Commonwealth University, Richmond, VA; The Cancer and Leukemia Group B (CALGB) Statistical Center, Durham, NC; University of Alabama at Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Wake Forest University, Winston-Salem, NC; Roswell Park Cancer Institute, Buffalo, NY; Duke University, Durham, NC; North Shore University, Manhasset, NY; University of Maryland, Baltimore, MD; and Dana Farber Cancer Institute, Boston, MA.
We investigated the relative prognostic significance of cytogenetics in 635 adult acute myeloid leukemia (AML) patients 60 years of age or older treated on front-line protocols. Classification trees and tree-structured survival analysis (TSSA) were used to identify important cytogenetic groups, and their prognostic significance was then assessed in multivariable analysis (MVA). Overall, 48.5% achieved complete remission (CR); 6.6% survived at 5 years. Complex karyotypes with at least 3 abnormalities (complex  3) and a group including "rare aberrations" predicted lower CR rates (25% and 30%) versus other patients (56%). Compared with complex 3, the odds of CR were significantly higher for noncomplex karyotypes without rare aberrations on MVA. Cytogenetically, complex 5 predicted inferior disease-free survival on TSSA, remaining significant on MVA together with white blood cell count (WBC), sex, and age. For survival, complex 5, rare aberrations, and core-binding factor (CBF) abnormalities were prognostic (P < .001), with 5-year survivals of 0%, 0%, and 19.4%, respectively, and 7.5% for remaining patients. Together with WBC, marrow blasts, sex, and age, the cytogenetic groups remained significant on MVA. In conclusion, pretreatment cytogenetics adds to other prognostic factors in older AML patients. Patients with complex 5 appear to benefit minimally from current treatment and are better suited for investigational therapy or supportive care. (Blood. 2006;108:63-73)
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
G. Juliusson, P. Antunovic, A. Derolf, S. Lehmann, L. Mollgard, D. Stockelberg, U. Tidefelt, A. Wahlin, and M. Hoglund
Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry
Blood,
April 30, 2009;
113(18):
4179 - 4187.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. D. Klepin and L. Balducci
Acute Myelogenous Leukemia in Older Adults
Oncologist,
March 1, 2009;
14(3):
222 - 232.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. A. Fehniger, J. C. Byrd, G. Marcucci, C. N. Abboud, C. Kefauver, J. E. Payton, R. Vij, and W. Blum
Single-agent lenalidomide induces complete remission of acute myeloid leukemia in patients with isolated trisomy 13
Blood,
January 29, 2009;
113(5):
1002 - 1005.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Buchner, W. E. Berdel, C. Haferlach, T. Haferlach, S. Schnittger, C. Muller-Tidow, J. Braess, K. Spiekermann, J. Kienast, P. Staib, et al.
Age-Related Risk Profile and Chemotherapy Dose Response in Acute Myeloid Leukemia: A Study by the German Acute Myeloid Leukemia Cooperative Group
J. Clin. Oncol.,
January 1, 2009;
27(1):
61 - 69.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Shah and J. E. Lancet
Frontline Treatment of Acute Myeloid Leukemia: Are We Making Progress?
ASCO Educational Book,
January 1, 2009;
2009(1):
372 - 377.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Sekeres, P. Elson, M. E. Kalaycio, A. S. Advani, E. A. Copelan, S. Faderl, H. M. Kantarjian, and E. Estey
Time from diagnosis to treatment initiation predicts survival in younger, but not older, acute myeloid leukemia patients
Blood,
January 1, 2009;
113(1):
28 - 36.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-V. Malfuson, A. Etienne, P. Turlure, T. de Revel, X. Thomas, N. Contentin, C. Terre, S. Rigaudeau, D. Bordessoule, N. Vey, et al.
Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia
Haematologica,
December 1, 2008;
93(12):
1806 - 1813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Blum
Post-remission therapy in acute myeloid leukemia: what should I do now?
Haematologica,
June 1, 2008;
93(6):
801 - 805.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Wandt, U. Schakel, F. Kroschinsky, G. Prange-Krex, B. Mohr, C. Thiede, U. Pascheberg, S. Soucek, M. Schaich, and G. Ehninger
MLD according to the WHO classification in AML has no correlation with age and no independent prognostic relevance as analyzed in 1766 patients
Blood,
February 15, 2008;
111(4):
1855 - 1861.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Baer, H. D. Klepin, and A. S. Artz
Acute Leukemia in Older Adults: Are We Treating Too Much or Too Little?
ASCO Educational Book,
January 1, 2008;
2008(1):
216 - 223.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Blum, R. B. Klisovic, B. Hackanson, Z. Liu, S. Liu, H. Devine, T. Vukosavljevic, L. Huynh, G. Lozanski, C. Kefauver, et al.
Phase I Study of Decitabine Alone or in Combination With Valproic Acid in Acute Myeloid Leukemia
J. Clin. Oncol.,
September 1, 2007;
25(25):
3884 - 3891.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Karp, B. D. Smith, M. J. Levis, S. D. Gore, J. Greer, C. Hattenburg, J. Briel, R. J. Jones, J. J. Wright, and A. D. Colevas
Sequential Flavopiridol, Cytosine Arabinoside, and Mitoxantrone: A Phase II Trial in Adults with Poor-Risk Acute Myelogenous Leukemia
Clin. Cancer Res.,
August 1, 2007;
13(15):
4467 - 4473.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Gardin, P. Turlure, T. Fagot, X. Thomas, C. Terre, N. Contentin, E. Raffoux, S. de Botton, C. Pautas, O. Reman, et al.
Postremission treatment of elderly patients with acute myeloid leukemia in first complete remission after intensive induction chemotherapy:results of the multicenter randomized Acute Leukemia French Association (ALFA) 9803 trial
Blood,
June 15, 2007;
109(12):
5129 - 5135.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Meshinchi and R. J. Arceci
Prognostic Factors and Risk-Based Therapy in Pediatric Acute Myeloid Leukemia
Oncologist,
March 1, 2007;
12(3):
341 - 355.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Agrawal, M. Unterberg, S. Koschmieder, U. zur Stadt, U. Brunnberg, W. Verbeek, T. Buchner, W. E. Berdel, H. Serve, and C. Muller-Tidow
DNA Methylation of Tumor Suppressor Genes in Clinical Remission Predicts the Relapse Risk in Acute Myeloid Leukemia
Cancer Res.,
February 1, 2007;
67(3):
1370 - 1377.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. P. Erba
Prognostic Factors in Elderly Patients with AML and the Implications for Treatment
Hematology,
January 1, 2007;
2007(1):
420 - 428.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Buchner, W. E. Berdel, C. Schoch, T. Haferlach, H. L. Serve, J. Kienast, S. Schnittger, W. Kern, J. Tchinda, A. Reichle, et al.
Changes in the Hierarchy of Risk Factors with Older Age in De-Novo Acute Myeloid Leukemia (AML).
Blood (ASH Annual Meeting Abstracts),
November 16, 2006;
108(11):
1977 - 1977.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. Frohling, R. F. Schlenk, S. Kayser, M. Morhardt, A. Benner, K. Dohner, H. Dohner, and for the German-Austrian AML Study Group
Cytogenetics and age are major determinants of outcome in intensively treated acute myeloid leukemia patients older than 60 years: results from AMLSG trial AML HD98-B
Blood,
November 15, 2006;
108(10):
3280 - 3288.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Mrozek and C. D. Bloomfield
Chromosome Aberrations, Gene Mutations and Expression Changes, and Prognosis in Adult Acute Myeloid Leukemia
Hematology,
January 1, 2006;
2006(1):
169 - 177.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Stock
Controversies in Treatment of AML: Case-based Discussion
Hematology,
January 1, 2006;
2006(1):
185 - 191.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
