KARYOTYPE IN ACUTE MYELOBLASTIC-LEUKEMIA - PROGNOSTIC-SIGNIFICANCE FOR BONE-MARROW TRANSPLANTATION IN FIRST REMISSION - A EUROPEAN GROUP FOR BLOOD AND MARROW TRANSPLANTATION STUDY

The presentation cytogenetic result was correlated with outcome for 99 9 patients with acute myeloblastic leukemia (AML) having bone marrow t ransplantation (BMT) in first complete remission (CR1). The karyotype at diagnosis was classified according to the modified Chicago classifi cation. Allogeneic BMT (AlloBMT) was performed in 500 patients and aut ologous BMT (ABMT) in 499 patients. For both groups, an abnormal chrom osome (abn) 5 and/or 7 or a hypodiploid karyotype had a poor outcome, whereas t(15;17), pseudodiploidy, hyperdiploidy and diploidy were asso ciated with a standard prognosis. Abn (16) and t(8;21) were also of st andard prognosis for ABMT, but favorable for AlloBMT. When comparing A lloBMT and ABMT in patients with favorable or standard cytogenetics, A lloBMT was of benefit for remission duration and leukemia-free surviva l (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 sur vival in AlloBMT. In ABMT, cytogenetics influenced relapse and LFS. We concluded that the karyotype at diagnosis had important prognostic im plication in AML grafted in CR1. (C) 1997 by The American Society of H ematology.