Comparative analysis of acute myeloid leukemia treatment results in the Sverdlovsk Regional Clinical Hospital №1
Alexander V. Vinogradov, Tatiana S. Konstantinova, Alexander F. Tomilov, Vladimir A. Shalaev, Elena V. Chepuryaeva, Julia V. Sveshnikova, Leonid N. Sharov, Natalia V. Vinogradova
Ural State Medical Academy, Sverdlovsk Regional Clinical Hospital N1, Ekaterinburg, Russia
Correspondence
Ural State Medical Academy, Sverdlovsk Regional Clinical Hospital N1, Ekaterinburg, Russia, Gurzufskaya Str., 11/1-4, 620086 Ekaterinburg, Russia, Phone: +7 (343) 2683648, Fax: +7 (343) 2120146
E-mail: vinogradov-av@ yandex.ru
Summary
Aim
To estimate the prognostic significance of cytogenetic abnormalities in acute myeloid leukemia (AML) patients—who were treated according to the following chemotherapy protocols: RHSC AML 01.99, 01.01, and >60 years old.
Methods
A total of 125 AML pts were treated with RHSC AML 01.99, 01.01 and >60 y.o. protocols from 1999 to 2008. The distribution of pts by protocol was as follows: AML 01.99 – 16, AML 01.01 – 84, and AML >60 y.o. – 25. The cytogenetic variants of AML according to the protocols are presented in Table 1.
Results
The results of the comparative analysis of treatment results are presented in Table 2.
The results of the comparative analysis of treatment according to cytogenetics are presented in Table 3.
The comparative analysis of overall survival (OS) and relapse-free survival (RFS) of AML pts according to cytogenetics is presented in Figures 1 and 2.
Thus, in AML pts treated by RHSC AML 01.99, 01.01, and >60 y.o. protocols, only inv(16) has a favorable prognostic significance. All other cytogenetic subtypes were associated with unfavorable prognosis.
Keywords
acute myeloid leukemia, treatment, cytogenetic abnormalities
Table 1.
Protocol | t(8;21), % | inv(16), % | 46,xy/46,xx, % | Others, % |
AML 01.01 | 20.3 | 18.8 | 26.1 | 34.8 |
AML 01.99 | - | 38.5 | 30.8 | 30.8 |
AML > 60 y.o. | - | 27.8 | 22.2 | 50.0 |
Table 2.
Characteristics | AML 01.01 | AML 01.99 | AML > 60 y.o. |
Early death | |||
n | 8 | 1 | 4 |
% | 9.5 | 6.3 | 16.0 |
Resistance | |||
n | 28 | 2 | 4 |
% | 33.3 | 12.5 | 16.0 |
Complete remission | |||
n | 48 | 13 | 17 |
% | 57.1 | 81.3 | 68.0 |
Relapses | |||
n | 18 | 5 | 5 |
% | 34.6 | 38.5 | 29.4 |
Remission death | |||
n | 7 | 2 | 1 |
% | 13.5 | 15.4 | 5.9 |
Table 3.
Characteristics | t(8;21) | Inv(16) | 46,xy/46,xx | t(9;22), abn(11q), etc. | Others |
Early death | - | 8.7 | 23.1 | 13.0 | - |
Resistance | 7.7 | 13.0 | 23.1 | 43.5 | 61.5 |
Complete remission | 92.3 | 78.3 | 57.7 | 43.5 | 38.5 |
Relapses | 50.0 | 11.1 | 66.7 | 40.0 | 40.0 |
Remission death | 16.7 | 11.1 | 13.3 | 10.0 | 20.0 |
Figure 1. Actuarial probability of AML pts’ OS according to cytogenetics
Figure 2. Actuarial probability of AML pts’ RFS according to cytogenetics