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Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia.

Publication ,  Journal Article
Medeiros, BC; Othus, M; Fang, M; Appelbaum, FR; Erba, HP
Published in: Haematologica
March 2015

Clonal heterogeneity is a hallmark of malignant transformation. In acute myeloid leukemia, acquired cytogenetic abnormalities are important independent predictors of initial response to therapy, remission duration, and overall survival. However, whether the presence of multiple cytogenetically characterized clones affects outcomes in acute myeloid leukemia is still not well defined. The aim of this study was to assess the prognostic impact of cytogenetic clonal heterogeneity in acute myeloid leukemia. This analysis included 1403 newly diagnosed acute myeloid leukemia patients fit for intensive chemotherapy, aged between 15 and 88 years, enrolled on Southwest Oncology Group protocols. The presence of multiple cytogenetic clones was found in 164 (24%) patients with abnormal karyotype. The proportion of patients with clonal heterogeneity increased with age, being present in 20% of patients under 40 years of age, but in 30% of those aged over 70 years (P=0.03). Clonal heterogeneity was significantly more common in association with unfavorable karyotype. Clonal heterogeneity was associated with decreased response rates and inferior event-free, relapse-free and overall survival, and was confirmed as an independent predictor of poor prognosis in multivariable analysis. Subgroup analysis showed that clonal heterogeneity adds prognostic information particularly in the unfavorable karyotype group. Our results confirm the negative prognostic impact of clonal heterogeneity in acute myeloid leukemia patients with abnormal karyotype. (clinicaltrials.gov identifiers: 014343329; 01338974; 00899171; 1059734; 01059734; 00899743; 0143329; 00023777; 00085709; 01360125; 00004217).

Duke Scholars

Published In

Haematologica

DOI

EISSN

1592-8721

Publication Date

March 2015

Volume

100

Issue

3

Start / End Page

331 / 335

Location

Italy

Related Subject Headings

  • Survival Analysis
  • Prognosis
  • Middle Aged
  • Male
  • Lymphocytes
  • Leukemia, Myeloid, Acute
  • Karyotyping
  • Immunology
  • Humans
  • Genetic Heterogeneity
 

Citation

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ICMJE
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Medeiros, B. C., Othus, M., Fang, M., Appelbaum, F. R., & Erba, H. P. (2015). Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia. Haematologica, 100(3), 331–335. https://doi.org/10.3324/haematol.2014.117267
Medeiros, Bruno C., Megan Othus, Min Fang, Frederick R. Appelbaum, and Harry P. Erba. “Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia.Haematologica 100, no. 3 (March 2015): 331–35. https://doi.org/10.3324/haematol.2014.117267.
Medeiros BC, Othus M, Fang M, Appelbaum FR, Erba HP. Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia. Haematologica. 2015 Mar;100(3):331–5.
Medeiros, Bruno C., et al. “Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia.Haematologica, vol. 100, no. 3, Mar. 2015, pp. 331–35. Pubmed, doi:10.3324/haematol.2014.117267.
Medeiros BC, Othus M, Fang M, Appelbaum FR, Erba HP. Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia. Haematologica. 2015 Mar;100(3):331–335.

Published In

Haematologica

DOI

EISSN

1592-8721

Publication Date

March 2015

Volume

100

Issue

3

Start / End Page

331 / 335

Location

Italy

Related Subject Headings

  • Survival Analysis
  • Prognosis
  • Middle Aged
  • Male
  • Lymphocytes
  • Leukemia, Myeloid, Acute
  • Karyotyping
  • Immunology
  • Humans
  • Genetic Heterogeneity