Premature chromosome condensation studies in human leukemia: 5. Prediction
of early relapse
WN Hittelman, SD Menegaz, KB McCredie and MJ Keating
Previous reports have suggested that the technique of premature chromosome
condensation (PCC) is useful for predicting relapse in patients with acute
leukemia. However, these studies involved patients had been in complete
remission (CR) for various periods of time and had heterogeneous
expectations for relapse. The purpose of this study was to further
determine the value of PCC in predicting relapse by examining the PCC
characteristics of bone marrow specimens from patients with acute leukemia
on a common therapeutic regimen after similar periods in CR. The remission
durations after the PCC determinations were compared between patients with
high or low proliferative potential indices (PPI, or the fraction of G1
cells in late G1 phase). Of 60 patients studied between two and eight weeks
after achieving CR, 14 of the 16 patients exhibiting high PPI values
(greater than or equal to 35) have relapsed. The mean time from PCC
measurement to relapse was 23 weeks. In contrast, only 19 of the 44
patients exhibiting low PPI values have relapsed, with an estimated mean
time to relapse of 68+ weeks. Likewise, of 38 patients studied between nine
and 15 weeks of CR, nine of the ten patients exhibiting high PPI values
have relapsed (mean time to relapse, 23 weeks), while only 16 of 28
patients with low PPI values have relapsed (estimated mean time to relapse,
54+ weeks). The predictive value of the PCC technique was found to be
independent of other prognostic factors for the duration of CR, and it
identified those patients within the poor prognostic category with a high
likelihood of imminent relapse. While similar trends were observed at later
time intervals in CR, the differences in relapse rate between patients with
high or low PPI values is not significant. These results confirm the
usefulness of the PCC technique in predicting relapse in acute leukemia and
could aid in the identification of patients who might benefit by an
alteration of therapeutic strategy.
Volume 64,
Issue 5,
pp. 1067-1073,
11/01/1984
Copyright © 1984 by The American Society of Hematology
