Clinical significance of complex karyotype at diagnosis in pediatric and adult patients with de novo acute promyelocytic leukemia treated with ATRA and chemotherapy

Although additional cytogenetic abnormalities (ACA) do not affect the prognosis of patients with t(15;17) acute promyelocytic leukemia (APL), the role of a complex karyotype (CK) is yet to be clarified. We aimed to investigate the relationship of CK with relapse incidence in 1559 consecutive APL pat...

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Autores: Labrador, J, Luno, E, Vellenga, E, Brunet, S, Gonzalez-Campose, J, Chillon, MC, Holowiecka, A, Esteve, J, Bergua, J, Gonzalez-Sanmiguel, JD, Gil, C, Tormo, M, Salamero, O, Manso, F, Fernandez, I, de laSerna, J, Moreno, MJ, Perez-Encinas, M, Krsnik, I, Ribera, JM, Cervera, J, Calasanz, MJ, Boluda, B, Sobas, M, Lowenberg, B, Sanz, MA, Montesinos, P, Palmer, L, Ciarlo, S, Bezares, F, Rojas, F, Longoni, H, Gelemur, M, Fazio, P, Canepa, C, Saba, S, Balladares, G, Negri, P, Giunta, M, Milone, J, Prates, MV, Lafalse, D, Sossa, C, Jaramillo, F, Mayer, J, Protivankova, M, Scwarz, J, Holowiecka-Goral, A, Jakubas, B, Skret-Norwicz, A, Bizgalska-Skrzypek, P, Pluta, A, Becht, R, Kielbinski, M, Watek, M, Paluszewska, M, Gadomska, A, Rzenno, E, Piszcz, J, Ejduk, A, Dobrzanska, J, Calbecka, M, Kostyra, A, Malek, M, Grosicki, S, Knopinska, W, de Heredia, JMB, Hernandez, JM, Arias, J, Ramos, F, Roman, A, de la Serna, J, Negri, S, Rayon, C, Fernandez-Calvo, FJ, Diaz-Mediavilla, J, Olave, M, Amutio, E, Pedro, C, Gorosquieta, A, Viguria, M, Zudaire, M, Molero, T, Sayas, MJ, Guardia, R, Rivas, C, Esquembre, C, Garcia, R, Alcala, A, Lopez, JA, Rubio, V, Amigo, ML, Linares, M, San Miguel, JDG, Deben, G, Escoda, L, de la Camara, R, Molines, A, Loureiro, C, Allegue, MJ, Amador, L, Marti, JM, Madero, L, Lassaletta, A, Cabezudo, M, Garcia-Larana, J, Rojas, R, Ortega, F, Penarrubia, MJ, Puente, F, Lopez-Ibor, B, Bergua, JM, Ibanez, J, Sanchez, P, Novo, A, Font, LL, Guinea, JM, Montero, A, Gonzalez, M, Martin, G, Martinez, J, Verdeguer, A, Garcia, P, Conde, E, Garcia, J, Capote, FJ, Bueno, J, Bastida, P, Rubio, A, Fuster, JL, Gonzalez, J, Perez, I, Molina, J, Mateos, MC, Ardaiz, MA, Rodriguez-calvillo, M, Poderos, C, Arnan, M, Duarte, R, Hernandez, JA, Diaz-Morfa, M, Martin-Chacon, E, Calvo-Villas, JM, Garcia-Belmonte, D, Hernandez-Maraver, D, Ossenkoppele, GJ, van der Lelie, J, Sonneveld, P, Zijlmans, M, Maertens, J, de Valk, B, Wijermans, PW, de Groot, MR, Schouten, HC, Biesma, DH, Kooy, MV, de Lisa, E, PETHEMA Grp, HOVON Grp, PALG Grp, GATLA Grp
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p7303
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/7303
Access Level:acceso abierto
Palabra clave:Acute promyelocytic leukemia
complex karyotype
ATRA
chemotherapy
prognostic
relapse
Descripción
Sumario:Although additional cytogenetic abnormalities (ACA) do not affect the prognosis of patients with t(15;17) acute promyelocytic leukemia (APL), the role of a complex karyotype (CK) is yet to be clarified. We aimed to investigate the relationship of CK with relapse incidence in 1559 consecutive APL patients enrolled in three consecutive trials. Treatment consisted of AIDA induction followed by risk-adapted consolidation. A CK (CK) was defined as the presence of >= 2 ACA, and a very CK (CK+) as >= 3 ACA. Eighty-nine patients (8%) had a CK, of whom 41 (4%) had CK+. The 5-year cumulative incidence of relapse (CIR) in patients with CK was 18%, and 12% in those with <2 ACA (p=.09). Among patients with CK+, the 5-year CIR was 27% vs 12% (p=.003), retaining the statistical significance in multivariate analysis. This study shows an increased risk of relapse among APL patients with CK + treated with ATRA plus chemotherapy front-line regimens.