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Blood.
2006 Nov 15;108(10):3280-8. Epub 2006 Jul 13.
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Cytogenetics and age are major determinants of
outcome in intensively treated acute myeloid
leukemia patients older than 60 years: results from
AMLSG trial AML HD98-B.
Frohling S,
Schlenk RF, Kayser S, Morhardt M, Benner A, Dohner
K, Dohner H; German-Austrian AML Study Group.
Department of Internal Medicine III, University
Hospital of Ulm, Robert-Koch-Str 8, 89081 Ulm,
Germany.
To assess the prognostic impact
of cytogenetics in elderly patients with acute
myeloid leukemia (AML) receiving intensive induction
and consolidation treatment according to a single
protocol specifically designed for patients above
age 60, pretreatment samples from 361 patients
registered for the AML HD98-B trial of the
German-Austrian AML Study Group were analyzed by
chromosome banding and fluorescence in situ
hybridization, and cytogenetic findings were
correlated with outcome. Using a proportional
hazards model with backward selection, 3 prognostic
subgroups were identified based on the influence of
cytogenetic abnormalities on overall survival (OS):
low-risk, t(15;17), and inv(16) in 25 of 361
patients (7%); standard-risk, normal karyotype,
t(8;21), t(11q23), +8 within a noncomplex karyotype,
and +11 within a noncomplex karyotype in 208 of 361
patients (58%); high-risk, all other aberrations in
128 of 361 patients (35%). On multivariate analysis,
high-risk cytogenetics (hazard ratio [HR], 2.24) and
age above 70 years (HR, 2.34) were independent
prognostic factors affecting OS, and stratification
according to these parameters demonstrated that a
large subgroup of patients (55%), characterized by
age 70 or older or high-risk cytogenetics, or both,
had very unfavorable treatment results despite
intensive chemotherapy. Thus, karyotype and age are
major determinants of outcome in elderly patients
with AML.
PMID: 16840728 [PubMed - indexed for
MEDLINE]