Identification of a group of AML/MDS patients with a relatively favorable prognosis who have chromosome 5 and/or 7 abnormalities

Background and Objectives. Patients with AML, RAEB-t or RAEB and abnormalit ies involving chromosomes 5 and/or 7 (-5, -7) generally, but not always, ha ve poorer prognoses than patients; with a normal karyotype. Our objective w as to see whether the occasional relatively favorable outcome in -5/-7 pati ents is a random event or, rather, reflects true heterogeneity In -5/-7, Design and Methods. We examined 3 factors known to be prognostic in AML for their prognostic significance in 400 -5/-7 patients treated at the M,D, An derson Cancer Center from 1980-1998 for AML or MDS. The outcome of comparat ive interest was ii survival as assessed by log-rank test. Results. There was evidence that outcome was better in -5/-7 patients with a simple (rather than complex) karyotype, with > 1 normal metaphase (rather than only metaphases containing -5/-7), and without an antecedent hematolo gic disorder. More importantly, the 10% of the patients with a simple karyo type, > 1 normal metaphase, and no antecedent hematologic disorder not only had a better outcome than the other -5/-7 patients but had essentially ide ntical outcomes to the 669 AML/MDS patients with a normal karyotype treated at M,D. Anderson during the same period. Interpretation and Conclusions. The results indicate that the -5/-7 group s hould not a priori be regarded as having an unfavorable prognosis, and more generally suggest the need to refine prognosis with in each of the cytogen etic subsets of AML. (C) Ferrata Slorti Foundation.