Secondary cytogenetic changes in acute promyelocytic leukemia--prognostic importance in patients treated with chemotherapy alone and association with the intron 3 breakpoint of the PML gene: a Cancer and Leukemia Group B study
| Autor: | S. Bigner, David Lawrence, Robert J. Mayer, R. Tantravahi, Charles A. Schiffer, A. J. Carroll, Kathleen W. Rao, Clara D. Bloomfield, F. R. Davey, D. C. Arthur, M. J. Pettenati, James L. Slack, Krzysztof Mrózek |
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| Rok vydání: | 1997 |
| Předmět: |
Oncology
Acute promyelocytic leukemia Adult Male Cancer Research medicine.medical_specialty Pathology Adolescent Receptors Retinoic Acid medicine.medical_treatment Translocation Genetic Promyelocytic leukemia protein Leukemia Promyelocytic Acute Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies Aged Chromosome Aberrations Chemotherapy Chromosomes Human Pair 15 biology business.industry Retinoic Acid Receptor alpha Daunorubicin Cytogenetics Cytarabine Myeloid leukemia Cancer Middle Aged medicine.disease Prognosis Leukemia biology.protein Chromosome abnormality Female business Chromosomes Human Pair 17 Chromosomes Human Pair 8 |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 15(5) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE To examine, in newly diagnosed patients with acute promyelocytic leukemia (APL), the prognostic significance of secondary cytogenetic changes and the relationship between such changes and the two major promyelocytic leukemia-retinoic acid receptor alpha (PML-RAR alpha) mRNA types. PATIENTS AND METHODS One hundred sixty-one patients with t(15;17)(q22;q11-12) enrolled onto Cancer and Leukemia Group B (CALGB) protocol 8461, a prospective study of cytogenetics in acute myeloid leukemia (AML), were studied. Eighty of these 161 patients were treated solely with chemotherapy and evaluated for response to treatment and survival. PML-RAR alpha mRNA type was determined using reverse transcriptase polymerase chain reaction (RT-PCR) in 56 patients. RESULTS The incidence of secondary cytogenetic abnormalities was 32%. Among 80 patients treated with chemotherapy, the presence of a secondary chromosome abnormality was associated with longer complete remission (CR) duration (median, 29.9 v 15.7 months; P = .03) and longer event-free survival (EFS) duration (median, 17.0 v 12.2 months; P = .03). There was no difference in overall survival (P = .28). In a separate group of 56 patients with both cytogenetic and molecular data, 32 had the type L PML-RAR alpha transcript (intron 6 PML breakpoint). Of these 32 patients, four (12.5%) had chromosome changes in addition to t(15;17), whereas 12 of 20 patients (60%) with the type 5 PML-RAR alpha transcript (intron 3 PML breakpoint) had secondary cytogenetic changes (P < .001). CONCLUSION (1) Secondary cytogenetic changes do not confer a poor prognosis in APL patients treated with anthracycline/cytarabine (Ara-C)-based chemotherapy; and (2) A highly significant relationship exists between the PML-RAR alpha 5 isoform (intron 3 PML genomic breakpoint) and secondary cytogenetic changes in APL. |
| Databáze: | OpenAIRE |
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