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Prepublished online as a Blood First Edition Paper on August 1, 2002; DOI 10.1182/blood-2002-03-0772. This Article Full Text (PDF) All Versions of this Article: 2002-03-0772v1 100/13/4325    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Byrd, J. C Articles by Bloomfield, C. D Search for Related Content PubMed PubMed Citation Articles by Byrd, J. C Articles by Bloomfield, C. D Social Bookmarking                   What's this? Submitted March 13, 2002 Accepted July 17, 2002 Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse and overall survival in adult patients with de novo acute myeloid leukemia: results from CALGB 8461 John C Byrd*, Krzysztof Mrozek, Richard K Dodge, Andrew J Carroll, Colin G Edwards, Diane C Arthur, Mark J Pettenati, Shivanand R Patil, Kathleen W Rao, Michael S Watson, Prasad R K Koduru, Joseph O Moore, Richard M Stone, Robert J Mayer, Eric J Feldman, Frederick R Davey, Charles A Schiffer, Richard A Larson, and Clara D Bloomfield The Ohio State University, Columbus, OH, USA CALGB Statistical Office, Durham, NC, USA University of Alabama at Birmingham, Birmingham, AL, USA National Cancer Institute, Bethesda, MD, USA Wake Forest University Medical Center, Winston Salem, NC, USA University of Iowa, Iowa City, IA, USA University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Washington University, St Louis, MO, USA North Shore University Hospital, Manhasset, NY, USA Duke University Medical Center, Durham, NC, USA Dana-Farber Cancer Institute, Boston, MA, USA Weill Medical College of Cornell University, New York, NY, USA SUNY Upstate Medical University, Syracuse, NY, USA Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA University of Chicago, Chicago, IL, USA * Corresponding author; email: byrd-3{at}medctr.osu.edu. We analyzed prospectively 1213 adults with de novo acute myeloid leukemia (AML) to ascertain the prognostic impact of cytogenetic abnormalities on complete remission (CR) rate, 5-year cumulative incidence of relapse (CIR), and 5-year overall survival (OS). All patients received similar induction therapy. Median follow-up for surviving patients was 8.3 years. Non-prioritized cytogenetics distinguished t(8;21) and inv(16)/t(16;16) as conferring a significantly better prognosis than normal karyotype. Prognostic impact of many abnormalities could not be determined independently because of their association with complex karyotype. Neither complex karyotype nor secondary aberrations affected outcome of patients with t(8;21), inv(16)/t(16;16) or t(9;11). Among other patients, those with complex karyotypes had significantly worse outcomes than cytogenetically normal patients. Based on outcome for specific cytogenetic abnormalities and karyotype complexity, patients were divided into three risk groups: favorable (CR 88%, CIR 54%, OS 55%), intermediate (67% CR, CIR 67%, OS 24%), and adverse (CR 32%, CIR 92%, OS 5%). Multivariate analyses confirmed the major contribution of cytogenetics to the probability of attaining CR, CIR and OS. For the adverse-risk group, the probability of achieving CR was 4.0 and 11.9 times lower, the probability of relapse 3.0 and 4.4 times higher, and the risk of death 2.1 and 4.3 times higher than those for the intermediate and favorable groups, respectively. We conclude that although the prognostic impact of many recurring abnormalities has not been ascertained independently of complex karyotype, cytogenetics is among the most useful factors predicting attainment of CR, CIR and long-term survival in adult AML. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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