Recent advances in genetic characterization of acute myeloid leukemia indicate that combined cytogenetic and molecular analyses provide better definition of prognostic groups. The aim of this study was to verify this prospectively in a large group of patients

A. Bardi

A. Cuneo

A. Piciocchi

Acute Leukemia Working Party of the GIMEMA group

B. Falini

B. Izzo

C. Mecucci

D. Cilloni

D. Diverio

F. Lo-Coco

F. Mandelli

F. Pane

G. Saglio

M. Mancini

M. Vignetti

N. Bolli

N. Testoni

P. Fazi

P.G. Pelicci

R. La Starza

S. Amadori

S. Iacobelli

Haematologica

Background Recent advances in genetic characterization of acute myeloid leukemia indicate that combined cytogenetic and molecular analyses provide better definition of prognostic groups. The aim of this study was to verify this prospectively in a large group of patients. Design and Methods Genetic characterization was prospectively carried out in 397 patients with acute myeloid leukemia (median age, 46 years) receiving uniform treatment according to the LAM99P protocol of the Italian GIMEMA group. The impact of genetic markers on response to therapy and outcome was assessed by univariate and multivariate analyses. Results For induction response, conventional karyotyping identified three groups with complete remission rates of 92%, 67% and 39% (p<0.0001). Complete remission rates in NPM1 mutated (NPM1+) and wild-type (NPM1-) groups were 76% and 60%, respectively, for the whole populations and 81% and 61% in the group with normal karyotype (p<0.001 and p=0.026, respectively). Multivariate analysis indicated that low risk karyotype and NPM1+ were independent factors favorably affecting complete remission. Multivariate analysis of overall and disease-free survival among 269 patients who achieved complete remission showed a significant impact of karyotype on both estimates and of FLT3 status on disease free-survival (FLT3-ITD vs. FLT3 wildtype, p=0.0001). NPM1 status did not significantly influence disease free-survival in either the whole population or in the patients with a normal karyotype in this series, probably due to the low number of cases analyzed. Conclusions These results reiterate the prognostic relevance of combining cytogenetic and mutational analysis in the diagnostic work up of patients with acute myeloid leukemia

F. Lo Coco

P. G. Pelicci

G. Saglio For The Acute Leukemia Working Party Of The Gimema Group

VIGNETTI, Marco

MANDELLI, Franco

Archivio della ricerca- Università di Roma La Sapienza

Prognostic impact of genetic characterization in the GIMEMA LAM99P multicenter study for newly diagnosed acute myeloid leukemia

Lo Coco, F

Cuneo, A

Pane, F

Cilloni, D

Diverio, D

Mancini, M

Testoni, N

Bardi, A

Izzo, B

Bolli, N

La Starza, R

Fazi, P

Iacobelli, S

Piciocchi, A

Vignetti, M

Amadori, S

Mandelli, F

Pelicci, P

Mecucci, C

Falini, B

Saglio, G

Cineca Institutional Research Information System

Francesco Lo Coco

Antonio Cuneo

Daniela Cilloni

Daniela Diverio

Marco Mancini

Nicoletta Testoni

Antonella Bardi

IZZO, BARBARA

Niccolò Bolli

Roberta La Starza

Paola Fazi

Simona Iacobelli

Alfonso Piciocchi

Marco Vignetti

Sergio Amadori

Franco Mandelli

Pier Giuseppe Pelicci

Cristina Mecucci

Brunangelo Falini

Giuseppe Saglio

Acute Leukemia Working

PANE, FABRIZIO

Archivio della ricerca - Università degli studi di Napoli Federico II

Prognostic impact of genetic characterization in the GIMEMA LAM99P multicenter study for newly diagnosed acute myeloid leukemia.

Lo-Coco, F

Archivio della Ricerca - Università di Roma Tor vergata

Recent advances in genetic characterization of acute myeloid leukemia indicate that combined cytogenetic and molecular analyses provide better definition of prognostic groups. The aim of this study was to verify this prospectively in a large group of patients. DESIGN AND METHODS: Genetic characterization was prospectively carried out in 397 patients with acute myeloid leukemia (median age, 46 years) receiving uniform treatment according to the LAM99P protocol of the Italian GIMEMA group. The impact of genetic markers on response to therapy and outcome was assessed by univariate and multivariate analyses. RESULTS: For induction response, conventional karyotyping identified three groups with complete remission rates of 92%, 67% and 39% (p<0.0001). Complete remission rates in NPM1 mutated (NPM1+) and wild-type (NPM1-) groups were 76% and 60%, respectively, for the whole population and 81% and 61% in the group with normal karyotype (p<0.001 and p=0.026, respectively). Multivariate analysis indicated that low risk karyotype and NPM1+ were independent factors favorably affecting complete remission. Multivariate analysis of overall and disease-free survival among 269 patients who achieved complete remission showed a significant impact of karyotype on both estimates and of FLT3 status on disease free-survival (FLT3-ITD vs. FLT3 wild-type, p=0.0001). NPM1 status did not significantly influence disease free-survival in either the whole population or in the patients with a normal karyotype in this series, probably due to the low number of cases analyzed. CONCLUSIONS: These results reiterate the prognostic relevance of combining cytogenetic and mutational analysis in the diagnostic work up of patients with acute myeloid leukemi

AIR Universita degli studi di Milano

LO COCO, FRANCESCO

IACOBELLI, SIMONA

AMADORI, SERGIO

Saglio, G.

English

https://art.torvergata.it/retrieve/handle/2108/59455/97980/Prognostic%20impact%20of%20genetic%20characterization%20in%20the.pdf

Prognostic impact of genetic characterization in the GIMEMA LAM99P multicenter study for newly diagnosed acute myeloid leukemia

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Archivio della ricerca- Università di Roma La Sapienza

Cineca Institutional Research Information System

Archivio della ricerca - Università degli studi di Napoli Federico II

Archivio della Ricerca - Università di Roma Tor vergata

AIR Universita degli studi di Milano

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