Clinical significance of chromosomal abnormalities and immunophenotype in adult acute myelogenous leukemia

Kong, Ok Nyu; Cheong, Jong Yun; Lee, Kyung Woo; Lee, Jung Hyun; Chung, Joo Seop; Lee, Eun Yup; Cho, Goon Jae

Abstract

BACKGROUND: This study was performed to identify the incidence and prognostic significance of chromosomal abnormalities as well as clinical significance of immuno phenotype in patients with acute myelogenous leukemia (AML).
METHODS
The chromosomal abnormalities, immunophenotype and their hematologic/clinical correlations were studied in 68 patients with de novo AML admitted to Pusan National University Hospital between January 1996 and December 2000. 47 of 68 patients had received induction chemotherapy and we analysed the response of treatment according to the karyotype pattern and immunophenotype.
RESULTS
The karyotypic patterns were divided into three groups; favorable (t (8;21), t (15;17) and inv (16); n=19, 28%), poor (-5, del (5q), -7, der (1;7), abn (3q) and complex karyotypes; n=11, 16%) and intermediate group (other abnormalities or normal karyotype; n=38, 56%). The incidence of chromosomal abnormalities was 56% (38/68) and overall complete remission (CR) rate of 47 evaluable patients was 64%. The CR rates of favorable, intermediate and poor groups were 88%, 59% and 44%, respectively (p=0.021). The median survival time of all patients was 7 months, those of poor and intermediate groups being 2 months and 6 months. The median survival time of favorable group was not reached (p=0.008). The overall 5 year survival rate was 38% and those of favorable, intermediate and poor groups were 68%, 31% and 9%, respectively (p=0.009). Expression of CD7, CD14, CD33, CD34 and terminal deoxynucleotidyl transferase had no impact on CR rate and overall survival. In multivariate analysis, both age and chromosomal abnormalities influence significantly on prognosis.
CONCLUSION
Cytogenetic study is important in predicting the outcome of patients with AML. And the treatment must be tailored according to the result of cytogenetics such as this study.