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.

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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19 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)143-151
Number of pages9
JournalInternational journal of oncology
Volume25
Issue number1
StatePublished - Jul 2004

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Farag, S. S., Ruppert, A. S., Mrózek, K., Carroll, A. J., Pettenati, M. J., Le Beau, M. M., Peterson, B. L., Powell, B. L., Ozer, H., Silver, R. T., Larson, R. A., & Bloomfield, C. D. (2004). 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. International journal of oncology, 25(1), 143-151.