BMSEHA15
Published online 10 November 2009
Haematologica, Vol 95, Issue 3, 424-431 doi:10.3324/haematol.2009.013243
Copyright © 2010 by Ferrata Storti Foundation
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Cervera, J.
Right arrow Articles by Sanz, M. A.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cervera, J.
Right arrow Articles by Sanz, M. A.

Acute Promyelocytic Leukemia

Additional chromosome abnormalities in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy

José Cervera1, Pau Montesinos1, Jesús M. Hernández-Rivas2, María J. Calasanz3, Anna Aventín4, María T. Ferro5, Elisa Luño6, Javier Sánchez7, Edo Vellenga8, Chelo Rayón6, Gustavo Milone9, Javier de la Serna10, Concha Rivas11, José D. González12, Mar Tormo13, Elena Amutio14, Marcos González2, Salut Brunet4, Bob Lowenberg15, Miguel A. Sanz1

1 Hospital Universitario La Fe, Valencia;
2 Hospital Clínico Universitario, Salamanca, Spain;
3 Universidad de Navarra, Pamplona, Spain;
4 Hospital Sant Pau, Barcelona, Spain;
5 Hospital Ramón y Cajal, Madrid, Spain;
6 Hospital Central de Asturias, Oviedo, Spain;
7 Hospital Universitario Virgen del Rocío, Sevilla, Spain;
8 University Hospital, Groningen, The Netherlands;
9 Fundaleu, Buenos Aires, Argentina;
10 Hospital 12 de Octubre, Madrid, Spain;
11 Hospital General, Alicante, Spain; Spain;
12 Hospital Insular, Las Palmas, Spain;
13 Hospital Clínico Universitario, Valencia, Spain;
14 Hospital de Cruces, Baracaldo, Spain and
15 Erasmus University Medical Center, Rotterdam, The Netherlands

Correspondence: Miguel A. Sanz, Hospital Universitario La Fe, Avenida Campanar, 21, 46009 Valencia, Spain. E-mail: msanz{at}uv.es

Background: Acute promyelocytic leukemia is a subtype of acute myeloid leukemia characterized by the t(15;17). The incidence and prognostic significance of additional chromosomal abnormalities in acute promyelocytic leukemia is still a controversial matter.

Design and Methods: Based on cytogenetic data available for 495 patients with acute promyelocytic leukemia enrolled in two consecutive PETHEMA trials (LPA96 and LPA99), we analyzed the incidence, characteristics, and outcome of patients with acute promyelocytic leukemia with and without additional chromosomal abnormalities who had been treated with all-trans retinoic acid plus anthracycline monochemotherapy for induction and consolidation.

Results: Additional chromosomal abnormalities were observed in 140 patients (28%). Trisomy 8 was the most frequent abnormality (36%), followed by abn(7q) (5%). Patients with additional chromosomal abnormalities more frequently had coagulopathy (P=0.03), lower platelet counts (P=0.02), and higher relapse-risk scores (P=0.02) than their counterparts without additional abnormalities. No significant association with FLT3/ITD or other clinicopathological characteristics was demonstrated. Patients with and without additional chromosomal abnormalities had similar complete remission rates (90% and 91%, respectively). Univariate analysis showed that additional chromosomal abnormalities were associated with a lower relapse-free survival in the LPA99 trial (P=0.04), but not in the LPA96 trial. However, neither additional chromosomal abnormalities overall nor any specific abnormality was identified as an independent risk factor for relapse in multivariate analysis.

Conclusions: The lack of independent prognostic value of additional chromosomal abnormalities in acute promyelocytic leukemia does not support the use of alternative therapeutic strategies when such abnormalities are found.

Key words: acute promyelocytic leukemia, additional chromosomal abnormalities, prognostic factors, all-trans retinoic acid, anthracycline.