Premium
Additional chromosomal abnormalities in patients with acute promyelocytic leukaemia (APL) do not confer poor prognosis: results of APL 93 trial
Author(s) -
de Botton Stéphane,
Chevret Sylvie,
Sanz Miguel,
Dombret Hervé,
Thomas Xavier,
Guerci Agnès,
Fey Martin,
Rayon Consuelo,
Huguet Françoise,
Sotto JeanJacques,
Gardin Claude,
Cony Makhoul Pascale,
Travade Philippe,
Solary Eric,
Fegueux Nathalie,
Bordessoule Dominique,
San Miguel Jesus,
Link Harmut,
Desablens Bernard,
Stamatoullas Aspasia,
Deconinck Eric,
Geiser K,
Hess U,
Maloisel Fréderic,
Castaigne Sylvie,
Preudhomme Claude,
Chomienne Christine,
Degos Laurent,
Fenaux Pierre,
the European Apl Group for
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2000.02442.x
Subject(s) - acute promyelocytic leukemia , medicine , incidence (geometry) , gastroenterology , chemotherapy , trisomy 8 , trisomy , hematology , cytogenetics , retinoic acid , biology , chromosome , genetics , physics , optics , gene
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.