Evidence map›Paper›PMID 31803284›Full record

ArticleJournal of medicine and life

Importance of assessing cytogenetic and molecular risk factors in acute myeloid leukemia therapy.

E C Coles, A Colita, R Momanu, N Berbec, A M Ivanescu, M Oprea, D Jardan, C Jardan, A Arghir, D Coriu and 1 more

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Article in Journal of medicine and life. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

E C ColesHematology Department, Coltea Clinical Hospital, Bucharest.
A ColitaHematology Department, Coltea Clinical Hospital, Bucharest.
R MomanuRoche Romania, Bucharest.
N BerbecHematology Department, Coltea Clinical Hospital, Bucharest.
A M IvanescuHematology Department, Coltea Clinical Hospital, Bucharest.
M OpreaHematology Department, Coltea Clinical Hospital, Bucharest.
D JardanFundeni Clinical Institute Bucharest.
C JardanFundeni Clinical Institute Bucharest.
A ArghirVictor Babes Institute Bucharest.
D Coriu"Carol Davila" University of Medicine and Pharmacy, Bucharest.
A R LupuHematology Department, Coltea Clinical Hospital, Bucharest.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute myeloid leukemia (AML) is a heterogeneous disease in clinical presentation, outcome and therapeutic response. Cytogenetic and molecular characteristics are important prognostic indicators allowing the identification of distinct subtypes of AML, prognostic stratification and risk-adapted treatment. We present our experience during 5 years, in which we treated 245 patients with AML, of which we could genetically characterize 48 cases (26 females, 22 males) with a median age of 52 years. Cytogenetic analysis was performed by GTG banding on cultures of marrow cells treated with colcemid. Molecular analysis used RT-PCR performed on ABI 9700 platform in order to identify the following fusion genes: E2A-PBX1, TEL-AML1, AML1-ETO, PML-RARα, MLL-AF4, CBFC-MYH11, BCR-ABL, SIL-TAL, and MLL-AF9as well as mutations in Flt3, NPM1, WT1 genes. Fourteen patients were older than 60 years. In 12 we performed cytogenetic analysis showing 5 cases with complex karyotype, 2 normal karyotypes, 1 case of del(21), del (9), 11q- and t(3;15) respectively as well as 2 unevaluable karyotypes. These anomalies were associated with a high incidence of secondary AMLs (10/14) and with a low remission (CR) rate (5/14). Out of the 35 patients younger than 60 years, 25 were evaluated by cytogenetics showing a high incidence of favorable cytogenetic changes: 6 anomalies of chromosome 16 (5 inv (16) and 1 t (16; 16)), 3 t (15; 17), 3 cases of t (8; 21) of which 2 with additional abnormalities, 7 normal karyotypes and 1 case of 7q-, -y,-3 and respectively -8 associated with +18. In 25 cases molecular analysis was performed showing alterations in 21 patients: 6 cases with AML/ETO, 3 PML/RAR, 7 Flt3 mutations (2 associated with NPM1 mutation) as well as 1 case of isolated mutation of NPM1 and respectively WT1. CR rate was of 28/35. All cases with t (15; 17) and PML/RAR as well all cases with t (8; 21) and/or AML/ETO achieved CR. Out of the 7 cases with Flt3 mutations only 4 achieved CR including the 2 cases with associated NPM1 mutations. In our experience, genetic characteristics correlate with other prognostic markers such as age and secondary leukemia; "favorable" genetic anomalies were associated with a high CR rate; association of t (8; 21) with additional abnormalities did not influence CR rate.

Indexed as

Acute myeloid leukemiaAML- acute myeloid leukemiaAPL- acute promyelocytic leukemiaAra-C- CytarabinaASCT- allogeneic stem cell transplantATRA- all trans retinoic acidcomplete remission, prognosisCR- complete remissioncytogenetic abnormalitiesDFS- disease free survivalEFS- event free survivalFAB- french- american- britishLdAC- low dose Ara-Cmolecular anomaliesMRD- minimal residual diseaseOS- overall survival

Identifiers

PMID31803284
PMCPMC6880215

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.