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Prognostic significance of additional cytogenetic abnormalities in newly diagnosed patients with Philadelphia chromosome-positive chronic myelogenous leukemia treated with interferon-alpha: a Cancer and Leukemia Group B study.
MedLine Citation:
PMID:  15201999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Secondary cytogenetic abnormalities at diagnosis of Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) have been associated with an inferior outcome in reported series of largely chemotherapy-treated patients. To date, no study has specifically focused on the prognostic significance of secondary karyotypic abnormalities, detected at the time of diagnosis, in interferon (IFN)-alpha treated patients. We compared the outcome of 29 newly diagnosed Ph+ CML patients with additional abnormalities to that of 234 sole Ph+ patients, treated on CALGB protocols with IFN-alpha alone or together with IFN-gamma or low-dose cytarabine. Complete and partial cytogenetic responses were achieved in 20 and 19% of sole Ph+ patients, compared to 23 and 18%, respectively, of patients with additional abnormalities (P=1.00). None of 4 patients with 'high-risk' secondary abnormalities [+8, +Ph and i(17)(q10)], for whom follow-up cytogenetic samples were available, achieved a cytogenetic response. With a median follow-up of 11.3 years, the median overall survival (OS) was 6.0 years for sole Ph+ patients compared to 7.5 years for patients with additional abnormalities (P=0.70), with corresponding 8-year OS of 36 and 38%, respectively. On multivariable analysis, only age (P<0.001) and white blood cell count (P=0.02) were associated with outcome. We conclude that, with the possible exception of +8, +Ph and i(17)(q10), additional chromosomal abnormalities at diagnosis are not associated with inferior outcome in Ph+ CML patients treated with IFN-alpha-based therapy.
Authors:
Sherif S Farag; Amy S Ruppert; Krzysztof Mrózek; Andrew J Carroll; Mark J Pettenati; Michelle M Le Beau; Bercedis L Peterson; Bayard L Powell; Howard Ozer; Richard T Silver; Richard A Larson; Clara D Bloomfield;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  International journal of oncology     Volume:  25     ISSN:  1019-6439     ISO Abbreviation:  Int. J. Oncol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-17     Completed Date:  2005-04-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9306042     Medline TA:  Int J Oncol     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  143-51     Citation Subset:  IM    
Affiliation:
The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA. farag-1@medctr.osu.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Humans
Interferon-alpha / therapeutic use*
Interferon-gamma / therapeutic use*
Karyotyping
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*,  genetics,  mortality
Male
Middle Aged
Prognosis
Survival Analysis
Time Factors
Grant Support
ID/Acronym/Agency:
CA02599/CA/NCI NIH HHS; CA03927/CA/NCI NIH HHS; CA04326/CA/NCI NIH HHS; CA04457/CA/NCI NIH HHS; CA07968/CA/NCI NIH HHS; CA08025/CA/NCI NIH HHS; CA101140/CA/NCI NIH HHS; CA11028/CA/NCI NIH HHS; CA11789/CA/NCI NIH HHS; CA12046/CA/NCI NIH HHS; CA12449/CA/NCI NIH HHS; CA16058/CA/NCI NIH HHS; CA16450/CA/NCI NIH HHS; CA21060/CA/NCI NIH HHS; CA31809/CA/NCI NIH HHS; CA31946/CA/NCI NIH HHS; CA31983/CA/NCI NIH HHS; CA32291/CA/NCI NIH HHS; CA35279/CA/NCI NIH HHS; CA35406/CA/NCI NIH HHS; CA37135/CA/NCI NIH HHS; CA41287/CA/NCI NIH HHS; CA45418/CA/NCI NIH HHS; CA47545/CA/NCI NIH HHS; CA47555/CA/NCI NIH HHS; CA47559/CA/NCI NIH HHS; CA47577/CA/NCI NIH HHS; CA47642/CA/NCI NIH HHS; CA77440/CA/NCI NIH HHS; CA77658/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Interferon-alpha; 82115-62-6/Interferon-gamma

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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