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Prognostic significance of chromosomal abnormalities at relapse in children with relapsed acute myeloid leukemia: A retrospective cohort study of the Relapsed AML 2001/01 Study
K. Klein, HB. Beverloo, M. Zimmermann, SC. Raimondi, C. von Neuhoff, V. de Haas, R. van Weelderen, J. Cloos, J. Abrahamsson, Y. Bertrand, M. Dworzak, A. Fynn, B. Gibson, SY. Ha, CJ. Harrison, H. Hasle, S. Elitzur, G. Leverger, A. Maschan, B....
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
34532968
DOI
10.1002/pbc.29341
Knihovny.cz E-resources
- MeSH
- Leukemia, Myeloid, Acute * genetics MeSH
- Chromosome Aberrations * MeSH
- Child MeSH
- Cohort Studies MeSH
- Humans MeSH
- Prognosis MeSH
- Recurrence MeSH
- Retrospective Studies MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: In addition to treatment response, cytogenetic and molecular aberrations are the most important prognostic factors in children with de novo acute myeloid leukemia (AML). However, little is known about cytogenetics at the time of relapse. METHODS: This international study analyzed the prognostic value of cytogenetic profiles and karyotypic changes in pediatric relapsed AML in relation to the probability of event-free (pEFS) and overall survival (pOS). For this purpose, cytogenetic reports from all patients registered on the Relapsed AML 2001/01 Study were reviewed and classified. RESULTS: Cytogenetic information at relapse was available for 403 (71%) of 569 registered patients. Frequently detected aberrations at relapse were t(8;21)(q22;q22) (n = 60) and inv(16)(p13.1q22)/t(16;16)(p13.1;q22) (n = 24), both associated with relatively good outcome (4-year pOS 59% and 71%, respectively). Monosomy 7/7q-, t(9;11)(p22;q23), t(10;11)(p12;q23), and complex karyotypes were associated with poor outcomes (4-year pOS 17%, 19%, 22%, and 22%, respectively). Of 261 (65%) patients for whom cytogenetic data were reliable at both diagnosis and relapse, pEFS was inferior for patients with karyotypic instability (n = 128, 49%), but pOS was similar. Unstable karyotypes with both gain and loss of aberrations were associated with inferior outcome. Early treatment response, time to relapse, and cytogenetic profile at time of relapse were the most important prognostic factors, both outweighing karytoypic instability per se. CONCLUSION: The cytogenetic subgroup at relapse is an independent risk factor for (event-free) survival. Cytogenetic assessment at the time of relapse is of high importance and may contribute to improved risk-adapted treatment for children with relapsed AML.
Clinical laboratory Dutch Childhood Oncology Group The Hague The Netherlands
Department of Clinical Genetics Erasmus MC University Medical Center Rotterdam The Netherlands
Department of Pathology St Jude Children's Research Hospital Memphis Tennessee USA
Department of Pediatric Hematology Oncology University Hospital Essen Essen Germany
Department of Pediatrics Aarhus University Hospital Skejby Aarhus Denmark
Department of Pediatrics Pediatric oncology Hong Kong Children's Hospital Hong Kong China
Department of Pediatrics Queen Silvia Children's Hospital Gothenburg Sweden
Hematopathology Department Assistance Publique Hopitaux de Paris Paris France
Oncology and Immunology Dmitriy Rogachev Federal Center for Pediatric Hematology Moscow Russia
Pediatric Hematology Oncology Hannover Medical School Hannover Germany
Schneider Children's Medical Center Sackler School of Medicine Tel Aviv University Tel Aviv Israel
References provided by Crossref.org
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