Biological and clinical features of trisomy 21 in adult patients with acute myeloid leukemia.

Abstract

INTRODUCTION:

Trisomy 21 is frequently noted in patients with AML. In adults, +21 has traditionally been considered an intermediate-risk cytogenetic aberration.

PATIENTS AND METHODS:

We analyzed 90 patients with newly diagnosed AML harboring +21. Four cytogenetic subgroups were defined based on associated cytogenetic abnormalities: +21 alone, +21 with favorable, +21 with intermediate, and +21 with unfavorable cytogenetics.

RESULTS:

Fifty-four percent of patients with +21 AML achieved a complete remission (CR) or CR with incomplete platelet recovery (CRp) after induction therapy with a trend toward improved CR/CRp rates in patients with +21 alone/+21 with favorable cytogenetics compared with patients with +21 with intermediate/+21 with unfavorable cytogenetics (76% vs. 50%; P = .057). Time to progression (TTP) was 12 months (range, 5-19) and overall survival (OS) was 9 months (range, 7-11) for the entire group. TTP was longer for patients with +21 alone (not reached) or with +21 with favorable cytogenetics (101 months) compared with those with +21 with intermediate cytogenetics (2 months) or +21 with unfavorable cytogenetics (11 months) (P = .02). Similarly, OS was improved in patients with +21 with favorable cytogenetics (not reached) or +21 alone (107 months), compared with +21 with unfavorable cytogenetics (9 months) or +21 with intermediate cytogenetics (8 months) (P < .001). The differences in TTP and OS were maintained on multivariate analysis (P = .04 and P = .001; respectively).

CONCLUSION:

Isolated +21 hitherto classified as intermediate-risk cytogenetics might actually behave as a favorable-risk cytogenetics in adult AML patients.

• Authors: Paolo Strati, Naval Daver, Farhad Ravandi, Naveen Pemmaraju, Sherry Pierce, Guillermo Garcia-Manero, Aziz Nazha, Tapan Kadia, Elias Jabbour, Gautam Borthakur, Stefan Faderl, Alfonso Quintas-Cardama, Hagop Kantarjian, Jorge Cortes
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 13 Suppl 2 Pg. S276-81 (Sep 2013) ISSN: 2152-2669 [Electronic] United States
• PMID: 23969309 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Inc.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cytogenetics
• Disease-Free Survival
• Down Syndrome (genetics, pathology)
• Female
• Humans
• Karyotyping
• Leukemia, Myeloid, Acute (genetics, pathology)
• Male
• Middle Aged
• Prognosis
• Treatment Outcome
• Young Adult