Prognostic impact of cytogenetic alterations in newly diagnosed acute myeloid leukemia treated with risk-adapted protocols

Abstract

Background and objective: In acute myeloid leukemia (AML), cytogenetic alterations have influence on treatment response and are essential for risk stratification, although some have uncertain prognostic relevance. In this study, the prognostic impact of cytogenetic alterations was analyzed in a series of newly diagnosed AML patients treated with risk-adapted protocols. Patients and method: The cytogenetic profile of 1417 adult patients diagnosed with de novo AML (without t(15;17) or PML::RARA) enrolled in the CETLAM cooperative group protocols from 1994 to 2012 was studied, and its impact on survival was evaluated. Results: Multivariable analysis showed that anomalies such as t(8;21) and inv(16)/t(16;16) predict a favorable prognosis, with no significant effect of additional anomalies on outcome. In contrast, abnormalities like monosomy of chromosome 7, structural alterations of chromosome 1, complex karyotype (5 or more abnormalities), and monosomal karyotype were associated with worse outcomes. Patients were classified into three prognostic groups based on their cytogenetic alterations, which demonstrated the effectiveness of the proposed system in predicting prognosis. Conclusion: This study confirms the prognostic impact of cytogenetic alterations in AML and their usefulness in stratifying patients into risk groups.