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. 2010 Mar;95(3):424-31.
doi: 10.3324/haematol.2009.013243. Epub 2009 Nov 10.

Additional chromosome abnormalities in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy

José Cervera  1 , Pau Montesinos, Jesús M Hernández-Rivas, María J Calasanz, Anna Aventín, María T Ferro, Elisa Luño, Javier Sánchez, Edo Vellenga, Chelo Rayón, Gustavo Milone, Javier de la Serna, Concha Rivas, José D González, Mar Tormo, Elena Amutio, Marcos González, Salut Brunet, Bob Lowenberg, Miguel A Sanz
Affiliations

Additional chromosome abnormalities in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy

José Cervera et al. Haematologica. 2010 Mar.

Abstract

Background: Acute promyelocytic leukemia is a subtype of acute myeloid leukemia characterized by the t(15;17). The incidence and prognostic significance of additional chromosomal abnormalities in acute promyelocytic leukemia is still a controversial matter.

Design and methods: Based on cytogenetic data available for 495 patients with acute promyelocytic leukemia enrolled in two consecutive PETHEMA trials (LPA96 and LPA99), we analyzed the incidence, characteristics, and outcome of patients with acute promyelocytic leukemia with and without additional chromosomal abnormalities who had been treated with all-trans retinoic acid plus anthracycline monochemotherapy for induction and consolidation.

Results: Additional chromosomal abnormalities were observed in 140 patients (28%). Trisomy 8 was the most frequent abnormality (36%), followed by abn(7q) (5%). Patients with additional chromosomal abnormalities more frequently had coagulopathy (P=0.03), lower platelet counts (P=0.02), and higher relapse-risk scores (P=0.02) than their counterparts without additional abnormalities. No significant association with FLT3/ITD or other clinicopathological characteristics was demonstrated. Patients with and without additional chromosomal abnormalities had similar complete remission rates (90% and 91%, respectively). Univariate analysis showed that additional chromosomal abnormalities were associated with a lower relapse-free survival in the LPA99 trial (P=0.04), but not in the LPA96 trial. However, neither additional chromosomal abnormalities overall nor any specific abnormality was identified as an independent risk factor for relapse in multivariate analysis.

Conclusions: The lack of independent prognostic value of additional chromosomal abnormalities in acute promyelocytic leukemia does not support the use of alternative therapeutic strategies when such abnormalities are found.

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Figures

Figure 1.
Figure 1.
Relapse-free survival of patients according to the presence of additional chromosomal abnormalities in the: (A) LPA96 and LPA99 trials, (B) LPA96 trial, and (C) LPA99 trial.
See this image and copyright information in PMC

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