101. Characteristics and outcome of patients with acute myeloid leukemia and trisomy 4.
- Author
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Kayser S, Martínez-Cuadrón D, Hanoun M, Stölzel F, Gil C, Reinhardt HC, Aguiar E, Schäfer-Eckart K, Burgues JMB, Steffen B, Bernal T, Krause SW, Riaza R, Schliemann C, Cervera J, Kaufmann M, Torres-Miñana L, Hänel M, Acuña-Cruz E, Jost E, Algarra JL, Crysandt M, Fransecky L, Cornago-Navascues J, Kraus S, Martinez-Lopez J, Einsele H, Niemann D, Neubauer A, Seggewiß-Bernhardt R, Scholl S, Klein SA, Schmid C, Schaich M, Schmidt-Hieber M, Zukunft S, Ho AD, Platzbecker U, Baldus CD, Müller-Tidow C, Thiede C, Bornhäuser M, Serve H, Levis M, Montesinos P, Röllig C, and Schlenk RF
- Subjects
- Female, Humans, Middle Aged, Mutation, Nucleophosmin, Prognosis, Retrospective Studies, Trisomy genetics, Male, Adolescent, Young Adult, Adult, Aged, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute therapy
- Abstract
We retrospectively studied 125 patients with acute myeloid leukemia and trisomy 4 (median age at diagnosis, 58 years; range, 16-77 years) treated between 2000 and 2019 within a multicenter study. Trisomy 4 was the sole abnormality in 28 (22%) patients and additional abnormalities were present in 97 (78%) patients. Twenty-two (22%) and 15 (15%) of 101 tested patients harbored NPM1 and FLT3-ITD mutations. Two (3%) of 72 tested patients had double CEBPA mutations. Data on response to intensive anthracycline-based induction therapy were available for 119 patients. Complete remission was achieved in 67% (n=80) and the early death rate was 5% (n=6). Notably, patients with trisomy 4 as sole abnormality had a complete remission rate of 89%. Allogeneic hematopoietic cell transplantation was performed in 40 (34%) patients, of whom 19 were transplanted in first complete remission. The median follow-up of the intensively treated cohort was 5.76 years (95% confidence interval [95% CI]: 2.99-7.61 years). The 5-year overall survival and relapse-free survival rates were 30% (95% CI: 22-41%) and 27% (95% CI: 18-41%), respectively. An Andersen-Gill regression model on overall survival revealed that favorable-risk according to the European LeukemiaNet classification (hazard ratio [HR]=0.34; P=0.006) and trisomy 4 as sole abnormality (HR=0.41; P=0.01) were favorable factors, whereas age with a difference of 10 years (HR=1.15; P=0.11), female gender (HR=0.74; P=0.20) and allogeneic hematopoietic cell transplantation (HR=0.64; P=0.14) did not have an significant impact. In our cohort, patients with trisomy 4 as their sole abnormality had a high complete remission rate and favorable clinical outcome. Allogeneic hematopoietic cell transplantation did not seem to improve overall survival.
- Published
- 2023
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