Ferrant A, Labopin M, Frassoni F, Prentice H G, Cahn J Y, Blaise D, Reiffers J, Visani G, Sanz M A, Boogaerts M A, Löwenberg B, Gorin N C
Cliniques Universitaires St Luc, Bruxelles, Belgium.
Blood. 1997 Oct 15;90(8):2931-8.
The presentation cytogenetic result was correlated with outcome for 999 patients with acute myeloblastic leukemia (AML) having bone marrow transplantation (BMT) in first complete remission (CR1). The karyotype at diagnosis was classified according to the modified Chicago classification. Allogeneic BMT (AlloBMT) was performed in 500 patients and autologous BMT (ABMT) in 499 patients. For both groups, an abnormal chromosome (abn) 5 and/or 7 or a hypodiploid karyotype had a poor outcome, whereas t(15;17), pseudodiploidy, hyperdiploidy and diploidy were associated with a standard prognosis. Abn (16) and t(8;21) were also of standard prognosis for ABMT, but favorable for AlloBMT. When comparing AlloBMT and ABMT in patients with favorable or standard cytogenetics, AlloBMT was of benefit for remission duration and leukemia-free survival (LFS). Patients with an unfavorable karyotype had a similar outcome, regardless of type of BMT. By multivariate analysis, cytogenetics at diagnosis had the strongest prognostic value for relapse, LFS, and survival in AlloBMT. In ABMT, cytogenetics influenced relapse and LFS. We concluded that the karyotype at diagnosis had important prognostic implication in AML grafted in CR1.
对999例首次完全缓解（CR1）期接受骨髓移植（BMT）的急性髓细胞白血病（AML）患者的细胞遗传学检查结果与预后进行了相关性分析。诊断时的核型根据改良的芝加哥分类法进行分类。500例患者接受了异基因BMT（AlloBMT），499例患者接受了自体BMT（ABMT）。对于两组患者，异常染色体（abn）5和/或7或亚二倍体核型预后较差，而t（15；17）、假二倍体、超二倍体和二倍体与标准预后相关。abn（16）和t（8；21）对ABMT来说也是标准预后，但对AlloBMT来说预后较好。在细胞遗传学良好或标准的患者中比较AlloBMT和ABMT时，AlloBMT对缓解持续时间和无白血病生存期（LFS）有益。核型不良的患者，无论接受何种类型的BMT，预后相似。多因素分析显示，诊断时的细胞遗传学对AlloBMT的复发、LFS和生存率具有最强的预后价值。在ABMT中，细胞遗传学影响复发和LFS。我们得出结论，诊断时的核型对CR1期接受移植的AML患者具有重要的预后意义。
