Failure matters: unsuccessful cytogenetics and unperformed cytogenetics are associated with a poor prognosis in a population‐based series of acute myeloid leukaemia |
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| Authors: | Vladimir Lazarevic Ann‐Sofi Hörstedt Bertil Johansson Petar Antunovic Rolf Billström Åsa Derolf Sören Lehmann Lars Möllgård Stefan Peterson Dick Stockelberg Bertil Uggla Lovisa Vennström Anders Wahlin Martin Höglund Gunnar Juliusson |
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| Affiliation: | 1. Department of Hematology and Coagulation, Sk?ne University Hospital, Lund, Sweden;2. Stem Cell Center, Lund University, Lund, Sweden;3. Regional Cancer Center in South Sweden, Sk?ne University Hospital, Lund, Sweden;4. Department of Clinical Genetics, University and Regional Laboratories Region Sk?ne, Lund, Sweden;5. Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden;6. Department of Hematology, Link?ping University Hospital, Link?ping, Sweden;7. Department of Medicine, Central Hospital Sk?vde, Sk?vde, Sweden;8. Department of Medicine, Division of Hematology, Karolinska University Hospital, Stockholm and Huddinge, Sweden;9. Department of Medicine, Sahlgrenska University Hospital, G?teborg, Sweden;10. Department of Medicine, ?rebro University Hospital, ?rebro, Sweden;11. Department of Radiation Sciences, Ume? University, Ume?, Sweden;12. Department of Hematology, Academic Hospital, Uppsala, Sweden |
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| Abstract: | Unsuccessful cytogenetics (UC) in patients with acute myeloid leukaemia (AML) treated on different SWOG trials was recently reported to be associated with increased age and dismal outcome. To ascertain whether this holds true also in unselected patients with AML, we retrieved all cytogenetic reports in cases from the population‐based Swedish AML Registry. Between 1997 and 2006, 1737 patients below 80 yr of age without myelosarcoma or acute promyelocytic leukaemia received intensive treatment. The frequencies of UC and unperformed cytogenetics (UPC) were 2.1% and 20%, respectively. The early death rates differed between the cytogenetic subgroups (P = 0.006) with the highest rates in patients with UC (14%) and UPC (12%) followed by high‐risk (HR) AML, intermediate risk (IR) and standard risk (SR) cases successfully karyotyped (8.6%, 5.9%, and 5.8%, respectively). The complete remission rate was lower in UC and UPC and HR compared with the other risk groups (P < 0.001). The overall five‐year survival rates were 25% for UC and 22% for UPC, whereas the corresponding frequencies for SR, IR and HR AML patients without UC and UPC were 64%, 31% and 15%, respectively. In conclusion, lack of cytogenetic data translates into a poor prognosis. |
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| Keywords: | unsuccessful metaphase analysis unperformed cytogenetics acute myeloid leukaemia karyotype survival |
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