Effect of additional cytogenetic abnormalities on survival in arsenic trioxide-treated acute promyelocytic leukemia

Frontline arsenic trioxide (ATO)–based treatment regimens achieve high rates of long-term relapse-free survival in treating acute promyelocytic leukemia (APL) and form the current standard of care. Refining prognostic estimates for newly diagnosed patients treated with ATO-containing regimens remain...

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Published in:Blood advances 2022-06, Vol.6 (11), p.3433-3439
Main Authors: Epstein-Peterson, Zachary D., Derkach, Andriy, Geyer, Susan, Mrózek, Krzysztof, Kohlschmidt, Jessica, Park, Jae H., Rajeeve, Sridevi, Stein, Eytan M., Zhang, Yanming, Iland, Harry, Campbell, Lynda J., Larson, Richard A., Poiré, Xavier, Powell, Bayard L., Stock, Wendy, Stone, Richard M., Tallman, Martin S.
Format: Article
Language:English
Subjects:
Arsenic Trioxide - adverse effects
Chromosome Aberrations
Humans
Karyotype
Leukemia, Promyelocytic, Acute - drug therapy
Leukemia, Promyelocytic, Acute - genetics
Myeloid Neoplasia
Prognosis
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Summary:Frontline arsenic trioxide (ATO)–based treatment regimens achieve high rates of long-term relapse-free survival in treating acute promyelocytic leukemia (APL) and form the current standard of care. Refining prognostic estimates for newly diagnosed patients treated with ATO-containing regimens remains important in continuing to improve outcomes and identify patients who achieve suboptimal outcomes. We performed a pooled analysis of exclusively ATO-treated patients at a single academic institution and from the ALLG APML4 and Alliance C9710 studies to determine the prognostic importance of additional cytogenetic abnormalities and/or complex karyotype. We demonstrated inferior event-free survival for patients harboring complex karyotype (hazard ratio [HR], 3.74; 95% confidence interval [CI], 1.63-8.56; P = .002), but not for patients harboring additional cytogenetic abnormalities (HR, 2.13; 95% CI, 0.78-5.82; P = .142). These data support a role for full karyotypic analysis of all patients with APL and indicate a need for novel treatment strategies to overcome the adverse effect of APL harboring complex karyotype. •Complex karyotype is associated with inferior event-free survival in patients who have acute promyelocytic leukemia treated with ATO. [Display omitted]
ISSN:2473-9529
2473-9537
DOI:10.1182/bloodadvances.2021006682