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Blood, 1 July 2002, Vol. 100, No. 1, pp. 29-35
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Impact of trisomy 8 (+8) on clinical presentation, treatment
response, and survival in acute myeloid leukemia: a Southwest
Oncology Group study
Sandra R. Wolman,
Holly Gundacker,
Frederick R. Appelbaum, and
Marilyn L. Slovak for the Southwest Oncology Group
From Wayne State University, Detroit, MI, and
Universities Associated for Research and Education in Pathology
(UAREP), Bethesda, MD; the Southwest Oncology Group Statistical
Center, Fred Hutchinson Cancer Research Center; the Fred Hutchinson
Cancer Research Center, Seattle, WA; Department of Cytogenetics, City
of Hope National Medical Center, Duarte, CA, for the Southwest Oncology
Group, San Antonio, TX.
The prognostic impact of trisomy 8, alone or with other clonal
aberrations, was evaluated in 849 patients with previously untreated
acute myeloid leukemia (AML) who were registered to 5 Southwest
Oncology Group trials. At presentation, 108 (12.7%) patients had +8 in
their karyotypes, including 43 (5.1%) patients with +8 as the sole
aberration; 307 (36.2%) were normal, and 434 (51.1%) had other
cytogenetic abnormalities. Patients with +8 were slightly older
(P = .033), had lower WBC (P = .011), and had lower percentages of peripheral blasts (P = .0004)
than the patients without +8. Median survival time for all patients
with +8 was 9.9 months (95% CI, 6.5-12.5), similar to that of
"unfavorable" cytogenetics risk groups (8.3 months; 95% CI,
6.8-9.5.) Patients with +8 had significantly lower peripheral blasts
(P = .0002), WBC (P < .0001) counts, and
decreased overall survival (OS) than patients with normal cytogenetics
(9.9 months vs 15.4 months; P = .006). However, survival
of patients with +8 as the sole aberration did not differ significantly
from those with normal cytogenetics (P = .36). Thus, the
trisomy 8 group as a whole had poor survival, which was largely
attributable to worsened outcomes among patients whose trisomy 8 was
associated with other unfavorable cytogenetic abnormalities.
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