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Published on: January 28, 2014
Impact of additional cytogenetic aberrations at diagnosis of chronic phase chronic myeloid leukemia
Fang Cheng1,2, Zheng Cui1,2, Qiang Li1,2
1Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Objective:
This study aimed to investigate the correlation between additional cytogenetic abnormalities (ACAs) at diagnosis and their clinical consequences in 337 Chinese chronic myeloid leukemia (CML) patients.
Design:
Retrospective observational cohort study.
Methods:
Response criteria were applied according to the European LeukemiaNet. Event-free survival (EFS) and progression-free survival (PFS) were analyzed. Independent predictors of PFS were assessed using Cox regression analysis.
Results:
At diagnosis, ACAs were identified in 41 patients (12.2%), with 24 exhibiting high-risk ACAs. Patients with high-risk ACAs showed significantly lower molecular response rates than those with low-risk ACAs or non-ACAs. Furthermore, patients with high-risk ACAs demonstrated diminished EFS (45.8% vs 76.5% vs 78.0%, respectively, p = 0.03) and PFS (54.2% vs 94.1% vs 93.9%, p < 0.001) compared with those in the other groups. In the multivariate analysis, both the EUTOS long-term survival (ELTS) score and high-risk ACAs at diagnosis emerged as independent prognostic factors influencing the cumulative major molecular response (MMR) rate and PFS. Moreover, when stratified according to high-risk ACAs and ELTS score, patients with high-risk ACAs alongside an intermediate/high ELTS score exhibited reduced MMR (p < 0.001) and inferior PFS rates (p = 0.0014).
Conclusion:
These findings underscore the importance of integrating cytogenetics-based risk assessments into CML management.
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