Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2001-2-22
pubmed:abstractText
The clinical significance of complex chromosome aberrations for adults with acute myeloid leukaemia (AML) was assessed in 920 patients with de novo AML who were karyotyped and treated within the German AML Cooperative Group (AMLCG) trials. Complex chromosome aberrations were defined as three or more numerical and/or structural chromosome aberrations excluding translocations t(8;21)(q22;q22), t(15;17)(q22;q11-q12) and inv(16)(p13q22). Complex chromosome anomalies were detected in 10% of all cases with a significantly higher incidence in patients > or = 60 years of age (17.8% vs. 7.8%, P < 0.0001). Clinical follow-up data were available for 90 patients. Forty-five patients were < 60 years of age and were randomly assigned to double induction therapy with either TAD-TAD [thioguanine, daunorubicin, cytosine arabinoside (AraC)] or TAD-HAM (high-dose AraC, mitoxantrone). Twenty-one patients achieved complete remission (CR) (47%), 20 patients (44%) were non-responders and 9% of patients died during aplasia (early death). The median overall survival (OS) was 7 months and the OS rate at 3 years was 12%. Patients receiving TAD-HAM showed a significantly higher CR rate than patients receiving TAD-TAD (56% vs. 23%, P = 0.04). Median event-free survival was less than 1 month in the TAD-TAD group and 2 months in the TAD-HAM group, respectively (P = 0.04), with a median OS of 4.5 months vs. 7.6 months (P = 0.13) and an OS after 3 years of 7.6% vs. 19.6%. Forty-five patients were > or = 60 years of age: 28 of these patient were treated for induction using one or two TAD courses and 17 cases received TAD-HAM with an age-adjusted reduction of the AraC dose. The CR rate was 44%, 38% were non-responders and 18% experienced early death. The median OS was 8 months and the OS rate at 3 years was 6%. In conclusion, complex chromosome aberrations in de novo AML predicted a dismal outcome, even when patients were treated with intensive chemotherapy. Patients under the age of 60 years with complex aberrant karyotypes may benefit from HAM treatment during induction. However, long-term survival rates are low and alternative treatment strategies for remission induction and consolidation are urgently needed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0007-1048
pubmed:author
pubmed:issnType
Print
pubmed:volume
112
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
118-26
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11167792-Acute Disease, pubmed-meshheading:11167792-Adult, pubmed-meshheading:11167792-Aged, pubmed-meshheading:11167792-Aged, 80 and over, pubmed-meshheading:11167792-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:11167792-Bone Marrow Transplantation, pubmed-meshheading:11167792-Chromosome Aberrations, pubmed-meshheading:11167792-Cytarabine, pubmed-meshheading:11167792-Cytogenetic Analysis, pubmed-meshheading:11167792-Daunorubicin, pubmed-meshheading:11167792-Disease-Free Survival, pubmed-meshheading:11167792-Female, pubmed-meshheading:11167792-Follow-Up Studies, pubmed-meshheading:11167792-Humans, pubmed-meshheading:11167792-Leukemia, Myeloid, pubmed-meshheading:11167792-Male, pubmed-meshheading:11167792-Middle Aged, pubmed-meshheading:11167792-Mitoxantrone, pubmed-meshheading:11167792-Prognosis, pubmed-meshheading:11167792-Remission Induction, pubmed-meshheading:11167792-Thioguanine
pubmed:year
2001
pubmed:articleTitle
Patients with de novo acute myeloid leukaemia and complex karyotype aberrations show a poor prognosis despite intensive treatment: a study of 90 patients.
pubmed:affiliation
Department of Internal Medicine III, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany. claudia.schoch@med3.med.uni-muenchen.de
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't