ISSN: 1300-7777 E-ISSN: 1308-5263
Significance of molecular-cytogenetic aberrations for the achievement of first remission in de novo acute myeloid leukemia [Turk J Hematol]
Turk J Hematol. 2008; 25(4): 190-194

Significance of molecular-cytogenetic aberrations for the achievement of first remission in de novo acute myeloid leukemia

Milena G. Velizarova1, Evgueniy A. Hadjiev2, Kamelia V. Alexandrova2, Dora N. Popova3, Ivanka Dimova4, Boriana M. Zaharieva4, Draga Toncheva4
1Department Of Clinical Laboratory And Clinical Immunology, University Alexander’s Hospital, Sofia, Bulgaria
2Clinic Of Hematology, University Alexander’s Hospital, Sofia, Bulgaria
3Department Of Blood Transfusion And Immunology, Lab Of Clinical Immunology, Hospital For Emergency Medicine "n. I. Pirogov", Sofia, Bulgaria
4Department Of Medical Genetics, Medical University, Sofia, Bulgaria

OBJECTIVE: The majority of adults diagnosed with acute myeloid leukemia (AML) display acquired cytogenetic aberrations at presentation. In this article, we present the major cytogenetic findings regarding AML and review their clinical significance for achievement of the first complete remission.
METHODS: We studied 71 adult patients with de novo AML, without previous myelodysplasia or alkylating therapy. Conventional cytogenetics and FISH were performed on bone marrow cells. The patients with AML were assigned to 12 subgroups according to established data for cytogenetic, molecular and general laboratory results. The selection of the analyzed parameters is consistent with internationally accepted “prognostic factors” in adult AML.
RESULTS: Complete remission upon induction therapy was achieved in 40% of cases (in a mean period of 2.3 months from therapy initiation). The patients with t(15;17) PML-RARA and inv(16)/CBFbeta-MYH11ë demonstrated the highest frequency of complete remission. Patients with hypodiploidy, t(9;22)/bcr-abl and complex karyotypes were therapy-resistant or died within the first three months after AML diagnosis.
CONCLUSION: Molecular-cytogenetic findings have an important significance for achievement of first complete remission. However, laboratory and biologic features (age, WBC and LDH) and type of AML have a large influence on the disease outcome.

Keywords: Cytogenetics, FISH, acute adult leukemia, molecular analysis.


Doğuştan olmayan akut miyeloid lösemiye yönelik ilk gerilemenin kazanılmasında moleküler sitogenetik aberasyonların önemi

Milena G. Velizarova1, Evgueniy A. Hadjiev2, Kamelia V. Alexandrova2, Dora N. Popova3, Ivanka Dimova4, Boriana M. Zaharieva4, Draga Toncheva4
1Department Of Clinical Laboratory And Clinical Immunology, University Alexander’s Hospital, Sofia, Bulgaria
2Clinic Of Hematology, University Alexander’s Hospital, Sofia, Bulgaria
3Department Of Blood Transfusion And Immunology, Lab Of Clinical Immunology, Hospital For Emergency Medicine "n. I. Pirogov", Sofia, Bulgaria
4Department Of Medical Genetics, Medical University, Sofia, Bulgaria

AMAÇ: Akut miyeloid lösemi (AML) teşhisi konulan yetişkinlerin büyük çoğunluğu edinsel sitogenetik aberasyona sahiptir. Bu makalede AML’ye ilişkin majör sitogenetik bulgular sunulmakta ve ilk tam remisyon üzerindeki klinik anlamları incelenmektedir.
YÖNTEMLER: Miyelodisplazi tanısı konulan ve akilleyici ilaçlarla tedavi edilen de novo AML li 71 hasta incelenmiştir. Konvensiyonel sitogenetik ve FISH yöntemleri ile kemik iliği hücreleri incelenmiştir. AML hastaları sitogenetik, moleküler ve genel laboratuar sonuçlarına göre 12 alt gruba ayrılmıştır. Analiz edilecek parametreler, uluslar arası olarak kabul gören yetişkin AML hastalarında "prognostik faktörler” ile uygun olarak seçilmiştir.
BULGULAR: İndüksiyon tedavisinden sonra vakaların %40’ında tam remisyon görülmüştür (tedavinin başlamasından itibaren ortalama 2.3 ay). Translokasyon (15;17) PML-RARA ve inv(16)/CBFbeta-MYH11Ñ olan hastaklarda en yüksek renmisyopn elde edildi. Hipodiploidi, t(9;22)/bcr-abl ve komplex karyotip hastalarının bir kısmı tedaviye dirençliydi kalan kısmı da AML teşhisinden sonraki ilk 3 ay içerisinde kaybedildi.
SONUÇ: Moleküler-sitogenetik bulgular ilk tam remisyonun elde edilmesinde anlamlı derecede önem taşımaktadır. Ancak laboratuar özellikleri ile biyolojik özellikler (yaş, lökosit ve LDH) ve AML tipinin hastalık outcome üzerinde büyük etkisi vardır.

Anahtar Kelimeler: Sitogenetik, FISH, akut yetişkin lösemi, moleküler analiz


Milena G. Velizarova, Evgueniy A. Hadjiev, Kamelia V. Alexandrova, Dora N. Popova, Ivanka Dimova, Boriana M. Zaharieva, Draga Toncheva. Significance of molecular-cytogenetic aberrations for the achievement of first remission in de novo acute myeloid leukemia. Turk J Hematol. 2008; 25(4): 190-194

Corresponding Author: Milena G. Velizarova, Bulgaria


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