TY - JOUR
T1 - Clinical significance of complex karyotype at diagnosis in pediatric and adult patients with de novo acute promyelocytic leukemia treated with ATRA and chemotherapy
AU - Labrador, Jorge
AU - Luño, Elisa
AU - Vellenga, Edo
AU - Brunet, Salut
AU - González-Campos, José
AU - Chillón, Maria C.
AU - Holowiecka, Aleksandra
AU - Esteve, Jordi
AU - Bergua, Juan
AU - González-Sanmiguel, José D.
AU - Gil, Cristina
AU - Tormo, Mar
AU - Salamero, Olga
AU - Manso, Felix
AU - Fernández, Isolda
AU - de laSerna, Javier
AU - Moreno, María José
AU - Pérez-Encinas, Manuel
AU - Krsnik, Isabel
AU - Ribera, Josep Maria
AU - Cervera, Jose
AU - Calasanz, María J.
AU - Boluda, Blanca
AU - Sobas, Marta
AU - Lowenberg, Bob
AU - Sanz, Miguel A.
AU - Montesinos, Pau
PY - 2019/4/16
Y1 - 2019/4/16
N2 - © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Although additional cytogenetic abnormalities (ACA) do not affect the prognosis of patients with t(15;17) acute promyelocytic leukemia (APL), the role of a complex karyotype (CK) is yet to be clarified. We aimed to investigate the relationship of CK with relapse incidence in 1559 consecutive APL patients enrolled in three consecutive trials. Treatment consisted of AIDA induction followed by risk-adapted consolidation. A CK (CK) was defined as the presence of ≥2 ACA, and a very CK (CK+) as ≥3 ACA. Eighty-nine patients (8%) had a CK, of whom 41 (4%) had CK+. The 5-year cumulative incidence of relapse (CIR) in patients with CK was 18%, and 12% in those with <2 ACA (p=.09). Among patients with CK+, the 5-year CIR was 27% vs 12% (p=.003), retaining the statistical significance in multivariate analysis. This study shows an increased risk of relapse among APL patients with CK + treated with ATRA plus chemotherapy front-line regimens.
AB - © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Although additional cytogenetic abnormalities (ACA) do not affect the prognosis of patients with t(15;17) acute promyelocytic leukemia (APL), the role of a complex karyotype (CK) is yet to be clarified. We aimed to investigate the relationship of CK with relapse incidence in 1559 consecutive APL patients enrolled in three consecutive trials. Treatment consisted of AIDA induction followed by risk-adapted consolidation. A CK (CK) was defined as the presence of ≥2 ACA, and a very CK (CK+) as ≥3 ACA. Eighty-nine patients (8%) had a CK, of whom 41 (4%) had CK+. The 5-year cumulative incidence of relapse (CIR) in patients with CK was 18%, and 12% in those with <2 ACA (p=.09). Among patients with CK+, the 5-year CIR was 27% vs 12% (p=.003), retaining the statistical significance in multivariate analysis. This study shows an increased risk of relapse among APL patients with CK + treated with ATRA plus chemotherapy front-line regimens.
KW - Acute promyelocytic leukemia
KW - ATRA
KW - chemotherapy
KW - complex karyotype
KW - prognostic
KW - relapse
U2 - 10.1080/10428194.2018.1522438
DO - 10.1080/10428194.2018.1522438
M3 - Article
C2 - 30526152
SN - 1042-8194
VL - 60
SP - 1146
EP - 1155
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
ER -