Additional chromosomal abnormalities in patients with acute promyelocytic leukaemia (APL) do not confer poor prognosis: results of APL 93 trial

被引：117

作者：

de Botton, S ^{[1
]}

Chevret, S ^{[1
]}

Sanz, M ^{[1
]}

Dombret, H ^{[1
]}

Thomas, X ^{[1
]}

Guerci, A ^{[1
]}

Fey, M ^{[1
]}

Rayon, C ^{[1
]}

Huguet, F ^{[1
]}

Sotto, JJ ^{[1
]}

Gardin, C ^{[1
]}

Makhoul, PC ^{[1
]}

Travade, P ^{[1
]}

Solary, E ^{[1
]}

Fegueux, N ^{[1
]}

Bordessoule, D ^{[1
]}

San Miguel, J ^{[1
]}

Link, H ^{[1
]}

Desablens, B ^{[1
]}

Stamatoullas, A ^{[1
]}

Deconinck, E ^{[1
]}

Geiser, K ^{[1
]}

Hess, U ^{[1
]}

Maloisel, F ^{[1
]}

Castaigne, S ^{[1
]}

Preudhomme, C ^{[1
]}

Chomienne, C ^{[1
]}

Degos, L ^{[1
]}

Fenaux, P ^{[1
]}

机构：

[1] CHU Lille, Serv Malad Sang, F-59037 Lille, France

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2000年 / 111卷 / 03期

关键词：

acute promyelocytic leukaemia; chromosomes; additional chromosomal rearrangements;

D O I：

10.1046/j.1365-2141.2000.02442.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In spite of the recent improvement in the outcome of acute promyelocytic leukaemia (APL) with treatment combining all trans retinoic acid (ATRA) and chemotherapy (CT), some patients with this disease still have a poor outcome. The prognostic significance of chromosomal abnormalities in addition to t(15;17) in APL is uncertain. We examined the prognostic significance of secondary chromosomal changes in 292 patients included in a European trial who were treated with ATRA and CT. The incidence of chromosomal abnormalities in addition to t(15;17) was 26% and trisomy 8 was the most frequent secondary change (46% of the cases with secondary changes). No significant differences were seen with regard to age, sex, initial white blood cell count, % of circulating blasts, platelet count, fibrinogen level and incidence of microgranular variants between patients with or without additional rearrangements. Outcome was also similar between patients with t(15;17) alone and patients with t(15;17) and other clonal abnormalities for complete remission (92% vs. 93% respectively), event-free survival at 2 years (76.1% vs. 78.1% respectively), relapse at 2 years (16.7% vs. 11.6% respectively) and overall survival at 2 years (79.9% vs. 79.5% respectively). Analysis according to the type of induction treatment (ATRA followed by CT or ATRA plus CT) or the type of maintenance treatment (with ATRA, low-dose CT or both) also failed to show any difference between the two groups. Thus, in a large cohort of APL patients treated with ATRA and CT, additional chromosomal abnormalities had no impact on prognosis.

引用

页码：801 / 806

页数：6

共 31 条

[1] PROPOSALS FOR CLASSIFICATION OF ACUTE LEUKEMIAS [J].

BENNETT, JM ;

CATOVSKY, D ;

DANIEL, MT ;

FLANDRIN, G ;

GALTON, DAG ;

GRALNICK, HR ;

SULTAN, C .

BRITISH JOURNAL OF HAEMATOLOGY, 1976, 33 (04) :451-&

[2] VARIANT FORM OF HYPERGRANULAR PROMYELOCYTIC LEUKEMIA (M3) [J].

BENNETT, JM ;

CATOVSKY, D ;

DANIEL, MT ;

FLANDRIN, G ;

GALTON, DAG ;

GRALNICK, HR ;

SULTAN, C .

ANNALS OF INTERNAL MEDICINE, 1980, 92 (02) :261-261

[3] CYTOGENETIC STUDIES IN ACUTE PROMYELOCYTIC LEUKEMIA - A SURVEY OF SECONDARY CHROMOSOMAL-ABNORMALITIES [J].

BERGER, R ;

LECONIAT, M ;

DERRE, J ;

VECCHIONE, D ;

JONVEAUX, P .

GENES CHROMOSOMES & CANCER, 1991, 3 (05) :332-337

[4] Presenting white blood cell count and kinetics of molecular remission predict prognosis in acute promyelocytic leukemia treated with all-trans retinoic acid:: Result of the randomized MRC trial [J].

Burnett, AK ;

Grimwade, D ;

Solomon, E ;

Wheatley, K ;

Goldstone, AH .

BLOOD, 1999, 93 (12) :4131-4143

[5]

Cox DR, 1972, J R STAT SOC B, V34, P487

[6] THE PML-RAR-ALPHA FUSION MESSENGER-RNA GENERATED BY THE T(15-17) TRANSLOCATION IN ACUTE PROMYELOCYTIC LEUKEMIA ENCODES A FUNCTIONALLY ALTERED RAR [J].

DETHE, H ;

LAVAU, C ;

MARCHIO, A ;

CHOMIENNE, C ;

DEGOS, L ;

DEJEAN, A .

CELL, 1991, 66 (04) :675-684

[7]

DOMBRET H, 1992, LEUKEMIA, V6, P1237

[8] A randomized comparison of all transretinoic acid (ATRA) followed by chemotherapy and ATRA plus chemotherapy and the role of maintenance therapy in newly diagnosed acute promyelocytic leukemia [J].

Fenaux, P ;

Chastang, C ;

Chevret, S ;

Sanz, M ;

Dombret, H ;

Archimbaud, E ;

Fey, M ;

Rayon, C ;

Huguet, F ;

Sotto, JJ ;

Gardin, C ;

Makhoul, PC ;

Travade, P ;

Solary, E ;

Fegueux, N ;

Bordessoule, D ;

San Miguel, J ;

Link, H ;

Desablens, B ;

Stamatoullas, A ;

Deconinck, E ;

Maloisel, F ;

Castaigne, S ;

Preudhomme, C ;

Degos, L .

BLOOD, 1999, 94 (04) :1192-1200

[9]

FENAUX P, 1993, BLOOD, V82, P3241

[10]

FENAUX P, 1992, BLOOD, V80, P2176

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