Ferrant A, Doyen C, Delannoy A, Straetmans N, Martiat P, Mineur P, Bosly A, Van den Berghe H, Michaux J L
Hematology Department, Université Catholique de Louvain, Brussels, Belgium.
Bone Marrow Transplant. 1995 May;15(5):685-90.
To evaluate the prognostic value of the karyotype in acute myeloblastic leukemia when patients are allocated to have either autologous bone marrow transplantation (BMT) or allogeneic BMT at the time of first remission (CR1), we have prospectively followed 134 consecutive patients from diagnosis. CR was achieved in 118 patients. Allogeneic BMT and autologous BMT were performed in 25 and 43 CR1 patients, respectively. Applying the karyotype classification of Keating et al for remission duration (favorable: t(15;17), inv(16); intermediate: normal, X -Y, t(8;21); unfavorable: other abnormalities), 10 patients had a favorable, 49 an intermediate, and 44 an unfavorable karyotype. The 5-year leukemia-free survival (LFS) probabilities for patients with a good, intermediate and unfavorable karyotype were 65%, 32% and 11%, respectively (log rank test P = 0.0019). The probabilities of relapse were 35% in patients with a favorable karyotype, 52% with an intermediate karyotype and 87% with an unfavorable karyotype (P = 0.0004). In the patients who had autologous BMT in CR1, the LFSs were 100%, 33% and 10% with favorable, intermediate and unfavorable karyotype, respectively (P = 0.04). The karyotype was of no prognostic value in patients receiving allogeneic BMT who had BMT in CR1. This study shows that the karyotype retains its prognostic value when the intentions is to treat patients with acute myeloblastic leukemia in CR1 with BMT. Autologous BMT was not able to improve the poor prognosis associated with an unfavorable karyotype.
为评估急性髓细胞白血病患者在首次缓解期（CR1）接受自体骨髓移植（BMT）或异基因BMT时核型的预后价值，我们从诊断开始对134例连续患者进行了前瞻性随访。118例患者实现了CR。25例CR1患者接受了异基因BMT，43例接受了自体BMT。应用基廷等人的核型分类评估缓解持续时间（良好：t(15;17)、inv(16)；中等：正常、X - Y、t(8;21)；不良：其他异常），10例患者核型良好，49例中等，44例不良。核型良好、中等和不良的患者5年无白血病生存率（LFS）分别为65%、32%和11%（对数秩检验P = 0.0019）。核型良好的患者复发概率为35%，中等核型为52%，不良核型为87%（P = 0.0004）。在CR1期接受自体BMT的患者中，核型良好、中等和不良的患者LFS分别为100%、33%和10%（P = 0.04）。核型对CR1期接受异基因BMT的患者无预后价值。本研究表明，当打算用BMT治疗CR1期急性髓细胞白血病患者时，核型保留其预后价值。自体BMT无法改善与不良核型相关的不良预后。
