PROGNOSTIC VALUE OF RESIDUAL NORMAL METAPHASES IN ACUTE MYELOGENOUS LEUKEMIA PATIENTS PRESENTING WITH ABNORMAL KARYOTYPE

Two hundred and forty-four untreated acute myelogenous leukemia (AML) patients with unfavorable karyotypes and 109 others with favorable ane uploid karyotypes were used to evaluate the prognostic significance of having both normal and abnormal metaphases (AN) vs only abnormal meta phases (AA) at AML presentation. The AA and AN groups were similar wit h respect to known prognostic variables. Among patients with unfavorab le karyotypes (-5, 5q-, -7, 7q-, and +8), the AN group had a significa ntly higher complete remission (CR) rate (46 vs 31%, P = 0.02), and a longer CR duration (P = 0.02) and survival (P = 0.026) than the AA gro up. The number of patients with other unfavorable karyotypes, such as t(11q23), were too small to evaluate properly. Among those with favora ble karyotypes (inv(16) and t(8;21)), on the other hand, both the AN a nd AA group had similar CR rate, CR duration, and survival. Similarly, in patients with t(15;17), CR duration of the AN and AA groups were s imilar. These data suggest that, among patients with abnormal karyotyp es, residual normal metaphases are associated with a higher CR rate, C R duration and survival, only in patients with unfavourable karyotypes , but not in those with favorable karyotypes.