Impact of Cytogenetic Evaluation on Prognosis of Patients with AML. S. Viditio1,3, K. Zamkoff1,3, T. Mercado2,3, D. Gladstone1,3, AL. Zaslav2,3. 1) Department of Blood And Marrow Stem Cell Transplatation Program; 2) Department of Clinical Pathology, Cytogenetics Laboratory; 3) SUNY at Stony Brook University Medical Center, Stony Brook NY 11794.
Non-random chromosome abnormalities are important, independent prognostic factors in AML. We report a study of 27 adults with AML. Cytogenetic aberrations were correlated with the median overall survival (MOS) of all patients (pts). Clinical features and outcome were examined. Cytogenetic analyses on 24, 48 and 72-hr cultures of bone marrow or unstimulated blood were performed using G-banding and/or FISH on 20 metaphase cells or 200 nuclei.
Among 27 pts, five (19%) had a normal karyotype and 22 (81%) had 1 clonal abnormalities. The pts were grouped according to the presence of a recurrent abnormality and were categorized as F, I or A risk groups.
F had six pts median age (MA) of 43 yr. Four had a t(8;21)(q22;q22) and two had a t(15;17)(q22;q22). The MOS in this group was 10.6 mo.
I had 16 pts (59%), MA of 60 yr. Five had normal karyotypes (18.5%), nine had +8 (33%). MOS was 7.8 mo. Nine of 27 had +8; and MOS of 8 mo. Five had +8 and additional abnormalities; MA of 65 yr and OS 4.9 mo. Trisomy 8 was also analyzed as a separate risk group, (nine pts). Four pts, MA of 49 yr, had only +8(15%) with MOS of 8.3 mo and five pts, MA of 65 yr, had +8, and other aberrations. MOS was only 4.9 mo. The difference in the outcomes of the two subgroups was significant. Pts with +8 and additional abnormalities had a worse MOS than patients with only +8.
A had 19 pts(70%). Ten pts had complex abnormalities. A had a MA of 63 yr and MOS 6.2 mo.
In summary, chromosome analysis is a critical independent determinant of the clinical outcome of AML. This study though limited, yielded significant data and was consistent with results from prior studies. We plan to incorporate a more aggressive approach to the use of cytogenetic data for diagnosis, treatment and prognosis in our practice.