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Blood, 15 December 2000, Vol. 96, No. 13, pp. 4075-4083

CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group study

Marilyn L. Slovak, Kenneth J. Kopecky, Peter A. Cassileth, David H. Harrington, Karl S. Theil, Anwar Mohamed, Elizabeth Paietta, Cheryl L. Willman, David R. Head, Jacob M. Rowe, Stephen J. Forman, and Frederick R. Appelbaum for the Southwest Oncology Group and the Eastern Cooperative Oncology Group

From the City of Hope National Medical Center, Duarte, CA.

The associations of cytogenetics with complete remission (CR) rates, overall survival (OS), and outcomes after CR were studied in 609 previously untreated AML patients younger than 56 years old in a clinical trial comparing 3 intensive postremission therapies: intensive chemotherapy, autologous transplantation (ABMT), or allogeneic bone marrow transplantation (alloBMT) from matched related donors. Patients were categorized into favorable, intermediate, unfavorable, and unknown cytogenetic risk groups based on pretreatment karyotypes. CR rates varied significantly (P < .0001) among the 4 groups: favorable, 84% (95% confidence interval [CI], 77%-90%); intermediate, 76% (CI, 71%-81%); unfavorable, 55% (CI, 48%-63%); and unknown, 54% (CI, 33%-74%). There was similar significant heterogeneity of OS (P < .0001), with the estimated relative risk of death from any cause being 1.50 (CI, 1.10-2.05), 3.33 (CI, 2.43-4.55), and 2.66 (CI, 1.59-4.45) for the intermediate, unfavorable, and unknown risk groups, respectively, compared with the favorable group. In multivariate analyses, the effects of cytogenetic risk status on CR rate and OS could not be explained by other patient or disease characteristics. Among postremission patients, survival from CR varied significantly among favorable, intermediate, and unfavorable groups (P = .0003), with significant evidence of interaction (P = .017) between the effects of treatment and cytogenetic risk status on survival. Patients with favorable cytogenetics did significantly better following ABMT and alloBMT than with chemotherapy alone, whereas patients with unfavorable cytogenetics did better with alloBMT. Cytogenetic risk status is a significant factor in predicting response of AML patients to therapy; however, to tighten treatment correlates within genetically defined AML subsets, a significantly larger leukemia cytogenetic database is warranted.

© 2000 by The American Society of Hematology.
 

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Adverse Prognostic Significance of KIT Mutations in Adult Acute Myeloid Leukemia With inv(16) and t(8;21): A Cancer and Leukemia Group B Study
J. Clin. Oncol., August 20, 2006; 24(24): 3904 - 3911.
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BloodHome page
C. Schmid, M. Schleuning, R. Schwerdtfeger, B. Hertenstein, E. Mischak-Weissinger, D. Bunjes, S. v. Harsdorf, C. Scheid, U. Holtick, H. Greinix, et al.
Long-term survival in refractory acute myeloid leukemia after sequential treatment with chemotherapy and reduced-intensity conditioning for allogeneic stem cell transplantation
Blood, August 1, 2006; 108(3): 1092 - 1099.
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BloodHome page
C. S. Wilson, G. S. Davidson, S. B. Martin, E. Andries, J. Potter, R. Harvey, K. Ar, Y. Xu, K. J. Kopecky, D. P. Ankerst, et al.
Gene expression profiling of adult acute myeloid leukemia identifies novel biologic clusters for risk classification and outcome prediction
Blood, July 15, 2006; 108(2): 685 - 696.
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BloodHome page
S. Faderl, S. Verstovsek, J. Cortes, F. Ravandi, M. Beran, G. Garcia-Manero, A. Ferrajoli, Z. Estrov, S. O'Brien, C. Koller, et al.
Clofarabine and cytarabine combination as induction therapy for acute myeloid leukemia (AML) in patients 50 years of age or older
Blood, July 1, 2006; 108(1): 45 - 51.
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BloodHome page
S. S. Farag, K. J. Archer, K. Mrozek, A. S. Ruppert, A. J. Carroll, J. W. Vardiman, M. J. Pettenati, M. R. Baer, M. B. Qumsiyeh, P. R. Koduru, et al.
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
Blood, July 1, 2006; 108(1): 63 - 73.
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M. Monzo, S. Brunet, A. Urbano-Ispizua, A. Navarro, G. Perea, J. Esteve, R. Artells, M. Granell, J. Berlanga, J. M. Ribera, et al.
Genomic polymorphisms provide prognostic information in intermediate-risk acute myeloblastic leukemia
Blood, June 15, 2006; 107(12): 4871 - 4879.
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F. R. Appelbaum, H. Gundacker, D. R. Head, M. L. Slovak, C. L. Willman, J. E. Godwin, J. E. Anderson, and S. H. Petersdorf
Age and acute myeloid leukemia
Blood, May 1, 2006; 107(9): 3481 - 3485.
[Abstract] [Full Text] [PDF]


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BloodHome page
J. M. Pagel, F. R. Appelbaum, J. F. Eary, J. Rajendran, D. R. Fisher, T. Gooley, K. Ruffner, E. Nemecek, E. Sickle, L. Durack, et al.
131I-anti-CD45 antibody plus busulfan and cyclophosphamide before allogeneic hematopoietic cell transplantation for treatment of acute myeloid leukemia in first remission
Blood, March 1, 2006; 107(5): 2184 - 2191.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
D. E. Hogge, L. Yalcintepe, S.-H. Wong, B. Gerhard, and A. E. Frankel
Variant Diphtheria Toxin-Interleukin-3 Fusion Proteins with Increased Receptor Affinity Have Enhanced Cytotoxicity against Acute Myeloid Leukemia Progenitors
Clin. Cancer Res., February 15, 2006; 12(4): 1284 - 1291.
[Abstract] [Full Text] [PDF]


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Y. Oki, H. M. Kantarjian, X. Zhou, J. Cortes, S. Faderl, S. Verstovsek, S. O'Brien, C. Koller, M. Beran, B. N. Bekele, et al.
Adult acute megakaryocytic leukemia: an analysis of 37 patients treated at M.D. Anderson Cancer Center
Blood, February 1, 2006; 107(3): 880 - 884.
[Abstract] [Full Text] [PDF]


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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]


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JCOHome page
G. Marcucci, C. D. Baldus, A. S. Ruppert, M. D. Radmacher, K. Mrozek, S. P. Whitman, J. E. Kolitz, C. G. Edwards, J. W. Vardiman, B. L. Powell, et al.
Overexpression of the ETS-Related Gene, ERG, Predicts a Worse Outcome in Acute Myeloid Leukemia With Normal Karyotype: A Cancer and Leukemia Group B Study
J. Clin. Oncol., December 20, 2005; 23(36): 9234 - 9242.
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S. Schnittger, C. Schoch, W. Kern, C. Mecucci, C. Tschulik, M. F. Martelli, T. Haferlach, W. Hiddemann, and B. Falini
Nucleophosmin gene mutations are predictors of favorable prognosis in acute myelogenous leukemia with a normal karyotype
Blood, December 1, 2005; 106(12): 3733 - 3739.
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R. G. W. Verhaak, C. S. Goudswaard, W. van Putten, M. A. Bijl, M. A. Sanders, W. Hugens, A. G. Uitterlinden, C. A. J. Erpelinck, R. Delwel, B. Lowenberg, et al.
Mutations in nucleophosmin (NPM1) in acute myeloid leukemia (AML): association with other gene abnormalities and previously established gene expression signatures and their favorable prognostic significance
Blood, December 1, 2005; 106(12): 3747 - 3754.
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M. Kalaycio, M. Sekeres, R. Sobecks, L. Rybicki, B. Pohlman, A. Advani, E. Kuczkowski, and B. Bolwell
Cytogenetic Classification Systems and Overall Survival Following Bone Marrow Transplant (BMT) for Acute Myelogenous Leukemia (AML).
Blood (ASH Annual Meeting Abstracts), November 16, 2005; 106(11): 4500 - 4500.
[Abstract]


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BloodHome page
R. E. Gale, R. Hills, P. D. Kottaridis, S. Srirangan, K. Wheatley, A. K. Burnett, and D. C. Linch
No evidence that FLT3 status should be considered as an indicator for transplantation in acute myeloid leukemia (AML): an analysis of 1135 patients, excluding acute promyelocytic leukemia, from the UK MRC AML10 and 12 trials
Blood, November 15, 2005; 106(10): 3658 - 3665.
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K. Kojima, M. Konopleva, I. J. Samudio, M. Shikami, M. Cabreira-Hansen, T. McQueen, V. Ruvolo, T. Tsao, Z. Zeng, L. T. Vassilev, et al.
MDM2 antagonists induce p53-dependent apoptosis in AML: implications for leukemia therapy
Blood, November 1, 2005; 106(9): 3150 - 3159.
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E. Jourdan, J.-M. Boiron, N. Dastugue, N. Vey, G. Marit, F. Rigal-Huguet, L. Molina, N. Fegueux, A. Pigneux, C. Recher, et al.
Early Allogeneic Stem-Cell Transplantation for Young Adults With Acute Myeloblastic Leukemia in First Complete Remission: An Intent-to-Treat Long-Term Analysis of the BGMT Experience
J. Clin. Oncol., October 20, 2005; 23(30): 7676 - 7684.
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S. Frohling, C. Scholl, D. G. Gilliland, and R. L. Levine
Genetics of Myeloid Malignancies: Pathogenetic and Clinical Implications
J. Clin. Oncol., September 10, 2005; 23(26): 6285 - 6295.
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JCOHome page
L. Bullinger and P. J.M. Valk
Gene Expression Profiling in Acute Myeloid Leukemia
J. Clin. Oncol., September 10, 2005; 23(26): 6296 - 6305.
[Abstract] [Full Text] [PDF]


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JCOHome page
C. Schmid, M. Schleuning, G. Ledderose, J. Tischer, and H.-J. Kolb
Sequential Regimen of Chemotherapy, Reduced-Intensity Conditioning for Allogeneic Stem-Cell Transplantation, and Prophylactic Donor Lymphocyte Transfusion in High-Risk Acute Myeloid Leukemia and Myelodysplastic Syndrome
J. Clin. Oncol., August 20, 2005; 23(24): 5675 - 5687.
[Abstract] [Full Text] [PDF]


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JCOHome page
G. Marcucci, K. Mrozek, A. S. Ruppert, K. Maharry, J. E. Kolitz, J. O. Moore, R. J. Mayer, M. J. Pettenati, B. L. Powell, C. G. Edwards, et al.
Prognostic Factors and Outcome of Core Binding Factor Acute Myeloid Leukemia Patients With t(8;21) Differ From Those of Patients With inv(16): A Cancer and Leukemia Group B Study
J. Clin. Oncol., August 20, 2005; 23(24): 5705 - 5717.
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Clin. Cancer Res.Home page
H. Tamura, K. Dan, K. Tamada, K. Nakamura, Y. Shioi, H. Hyodo, S.-D. Wang, H. Dong, L. Chen, and K. Ogata
Expression of Functional B7-H2 and B7.2 Costimulatory Molecules and Their Prognostic Implications in De novo Acute Myeloid Leukemia
Clin. Cancer Res., August 15, 2005; 11(16): 5708 - 5717.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. S. Tallman, D. G. Gilliland, and J. M. Rowe
Drug therapy for acute myeloid leukemia
Blood, August 15, 2005; 106(4): 1154 - 1163.
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Ann OncolHome page
C.-C. Chen, C.-F. Yang, M.-H. Yang, K.-D. Lee, W.-K. Kwang, J.-Y. You, Y.-B. Yu, C.-H. Ho, C.-H. Tzeng, W.-K. Chau, et al.
Pretreatment prognostic factors and treatment outcome in elderly patients with de novo acute myeloid leukemia
Ann. Onc., August 1, 2005; 16(8): 1366 - 1373.
[Abstract] [Full Text] [PDF]


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B. Z. Carter, M. Gronda, Z. Wang, K. Welsh, C. Pinilla, M. Andreeff, W. D. Schober, A. Nefzi, G. R. Pond, I. A. Mawji, et al.
Small-molecule XIAP inhibitors derepress downstream effector caspases and induce apoptosis of acute myeloid leukemia cells
Blood, May 15, 2005; 105(10): 4043 - 4050.
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D. A. Breems, W. L.J. Van Putten, P. C. Huijgens, G. J. Ossenkoppele, G. E.G. Verhoef, L. F. Verdonck, E. Vellenga, G. E. De Greef, E. Jacky, J. Van der Lelie, et al.
Prognostic Index for Adult Patients With Acute Myeloid Leukemia in First Relapse
J. Clin. Oncol., March 20, 2005; 23(9): 1969 - 1978.
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NEJMHome page
B. Falini, C. Mecucci, E. Tiacci, M. Alcalay, R. Rosati, L. Pasqualucci, R. La Starza, D. Diverio, E. Colombo, A. Santucci, et al.
Cytoplasmic Nucleophosmin in Acute Myelogenous Leukemia with a Normal Karyotype
N. Engl. J. Med., January 20, 2005; 352(3): 254 - 266.
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NEJMHome page
K. K. Ballen and R. P. Hasserjian
Case 2-2005 - A 39-Year-Old Woman with Headache, Stiff Neck, and Photophobia
N. Engl. J. Med., January 20, 2005; 352(3): 274 - 283.
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S. S. Farag, A. S. Ruppert, K. Mrozek, R. J. Mayer, R. M. Stone, A. J. Carroll, B. L. Powell, J. O. Moore, M. J. Pettenati, P. R.K. Koduru, et al.
Outcome of Induction and Postremission Therapy in Younger Adults With Acute Myeloid Leukemia With Normal Karyotype: A Cancer and Leukemia Group B Study
J. Clin. Oncol., January 20, 2005; 23(3): 482 - 493.
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J. J. Cornelissen and B. Lowenberg
Role of Allogeneic Stem Cell Transplantation in Current Treatment of Acute Myeloid Leukemia
Hematology, January 1, 2005; 2005(1): 151 - 155.
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S. Castaigne, S. Chevret, E. Archimbaud, P. Fenaux, D. Bordessoule, H. Tilly, T. de Revel, M. Simon, B. Dupriez, M. Renoux, et al.
Randomized comparison of double induction and timed-sequential induction to a "3 + 7" induction in adults with AML: long-term analysis of the Acute Leukemia French Association (ALFA) 9000 study
Blood, October 15, 2004; 104(8): 2467 - 2474.
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G. Marcucci, K. Mrozek, A. S. Ruppert, K. J. Archer, M. J. Pettenati, N. A. Heerema, A. J. Carroll, P. R.K. Koduru, J. E. Kolitz, L. J. Sterling, et al.
Abnormal Cytogenetics at Date of Morphologic Complete Remission Predicts Short Overall and Disease-Free Survival, and Higher Relapse Rate in Adult Acute Myeloid Leukemia: Results From Cancer and Leukemia Group B Study 8461
J. Clin. Oncol., June 15, 2004; 22(12): 2410 - 2418.
[Abstract] [Full Text] [PDF]


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NEJMHome page
L. Bullinger, K. Dohner, E. Bair, S. Frohling, R. F. Schlenk, R. Tibshirani, H. Dohner, and J. R. Pollack
Use of Gene-Expression Profiling to Identify Prognostic Subclasses in Adult Acute Myeloid Leukemia
N. Engl. J. Med., April 15, 2004; 350(16): 1605 - 1616.
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NEJMHome page
P. J.M. Valk, R. G.W. Verhaak, M. A. Beijen, C. A.J. Erpelinck, S. B. v. W. van Doorn-Khosrovani, J. M. Boer, H. B. Beverloo, M. J. Moorhouse, P. J. van der Spek, B. Lowenberg, et al.
Prognostically Useful Gene-Expression Profiles in Acute Myeloid Leukemia
N. Engl. J. Med., April 15, 2004; 350(16): 1617 - 1628.
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P. L. Greenberg, S. J. Lee, R. Advani, M. S. Tallman, B. I. Sikic, L. Letendre, K. Dugan, B. Lum, D. L. Chin, G. Dewald, et al.
Mitoxantrone, Etoposide, and Cytarabine With or Without Valspodar in Patients With Relapsed or Refractory Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome: A Phase III Trial (E2995)
J. Clin. Oncol., March 15, 2004; 22(6): 1078 - 1086.
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J. C. Byrd, A. S. Ruppert, K. Mrozek, A. J. Carroll, C. G. Edwards, D. C. Arthur, M. J. Pettenati, J. Stamberg, P. R.K. Koduru, J. O. Moore, et al.
Repetitive Cycles of High-Dose Cytarabine Benefit Patients With Acute Myeloid Leukemia and inv(16)(p13q22) or t(16;16)(p13;q22): Results from CALGB 8461
J. Clin. Oncol., March 15, 2004; 22(6): 1087 - 1094.
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S. Frohling, R. F. Schlenk, I. Stolze, J. Bihlmayr, A. Benner, S. Kreitmeier, K. Tobis, H. Dohner, and K. Dohner
CEBPA Mutations in Younger Adults With Acute Myeloid Leukemia and Normal Cytogenetics: Prognostic Relevance and Analysis of Cooperating Mutations
J. Clin. Oncol., February 15, 2004; 22(4): 624 - 633.
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J. M. Rowe, D. Neuberg, W. Friedenberg, J. M. Bennett, E. Paietta, A. Z. Makary, J. L. Liesveld, C. N. Abboud, G. Dewald, F. A. Hayes, et al.
A phase 3 study of three induction regimens and of priming with GM-CSF in older adults with acute myeloid leukemia: a trial by the Eastern Cooperative Oncology Group
Blood, January 15, 2004; 103(2): 479 - 485.
[Abstract] [Full Text] [PDF]


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P. C. Nathan, L. Sung, M. Crump, and J. Beyene
Consolidation Therapy With Autologous Bone Marrow Transplantation in Adults With Acute Myeloid Leukemia: A Meta-analysis
J Natl Cancer Inst, January 7, 2004; 96(1): 38 - 45.
[Abstract] [Full Text] [PDF]


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ASH Education BookHome page
R. M. Stone, M. R. O'Donnell, and M. A. Sekeres
Acute Myeloid Leukemia
Hematology, January 1, 2004; 2004(1): 98 - 117.
[Abstract] [Full Text] [PDF]


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BloodHome page
C. Schoch, S. Schnittger, M. Klaus, W. Kern, W. Hiddemann, and T. Haferlach
AML with 11q23/MLL abnormalities as defined by the WHO classification: incidence, partner chromosomes, FAB subtype, age distribution, and prognostic impact in an unselected series of 1897 cytogenetically analyzed AML cases
Blood, October 1, 2003; 102(7): 2395 - 2402.
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C. D. Baldus, S. M. Tanner, A. S. Ruppert, S. P. Whitman, K. J. Archer, G. Marcucci, M. A. Caligiuri, A. J. Carroll, J. W. Vardiman, B. L. Powell, et al.
BAALC expression predicts clinical outcome of de novo acute myeloid leukemia patients with normal cytogenetics: a Cancer and Leukemia Group B Study
Blood, September 1, 2003; 102(5): 1613 - 1618.
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S. Suciu, F. Mandelli, T. de Witte, R. Zittoun, E. Gallo, B. Labar, G. De Rosa, A. Belhabri, R. Giustolisi, R. Delarue, et al.
Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trial
Blood, August 15, 2003; 102(4): 1232 - 1240.
[Abstract] [Full Text] [PDF]



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