PATIENTS WITH ISOLATED TRISOMY-8 IN ACUTE MYELOID-LEUKEMIA ARE NOT CURED WITH CYTARABINE-BASED CHEMOTHERAPY - RESULTS FROM CANCER AND LEUKEMIA GROUP-B-8461

To date, neither the clinical significance of isolated trisomy 8, the most frequent trisomy in acute myeloid leukemia (AML), nor the effect of age within a single cytogenetic group has been examined. We report a large cohort of adult trisomy 8 patients and examine whether increas ing age within a homogeneous cytogenetic group alters clinical outcome . Characteristics and outcome of patients with isolated trisomy 8 enro lled in the prospective Cancer and Leukemia Group B (CALGB) cytogeneti c study CALGB 8461 are described. Isolated trisomy 8 was identified in 42 (3.03%) of 1387 patients enrolled in five CALGB treatment protocol s. These patients had a median age of 64 (range, 16-79) years, 50% fem ale proportion, and a low frequency of hepatomegaly (10%) or splenomeg aly (10%), Laboratory features included a median white blood count of 7.3 x 10(9)/L, nonspecific French-American-British distribution, with 36% of patients having Auer rods. Treatment outcome was unsatisfactory with a complete remission (CR) rate of 59%, median CR duration of 13. 6 months, and median survival of 13.1 months, Older age adversely affe cted outcome; trisomy 8 patients greater than or equal to 60 years had both an inferior CR rate (40% versus 88%; P = 0.004) and overall surv ival (median, 4.8 versus 17.5 months; P = 0.01), as compared with thos e <60 years of age. Of the patients <60 years of age, only four remain alive, and all received noncytarabine-based intensive chemotherapy, f ollowed in three cases by autologous (n = 2) or allogeneic (n = 1) ste m cell transplant in CR1, Adults with AML and isolated trisomy 8 have a poor outcome that is accentuated by increasing age and is rarely cur ed with cytarabine-based therapy, Alternative investigational treatmen ts should be considered for individuals with this AML subset.