Independent prognostic significance of day 21 cytogenetic findings in newly-diagnosed acute myeloid leukemia or refractory anemia with excess blasts

Abstract

BACKGROUND AND OBJECTIVES: We investigated whether cytogenetic findings (CG) on day 21 (D21) of the first course of chemotherapy predicted subsequent outcome in patients who presented with CG abnormalities. DESIGN AND METHODS: D21 CG analysis was performed in 197 patients. RESULTS: Nineteen percent of the patients had exclusively abnormal metaphases (AA), 31% had only normal metaphases (NN), 39% had normal and abnormal metaphases (AN), and 11% had insufficient metaphases (0/0) on D21. A complete response was achieved in 79% of patients with NN, 60% with AN, 27% of those with AA, and 32% of those with 0/0. INTERPRETATIONS AND CONCLUSIONS: Disease-free survival in CR was longest in patients who had > or =1 normal metaphase on D21, with this finding being independent of D21 marrow and initial CG results. D21 CG can be used in therapeutic decision-making.