Influence of cytogenetic abnormalities on outcome after allogeneic bone marrow transplantation for XXXX in first complete remission.

@entity1 @entity3432 @entity6158 @entity786 @entity3052 @entity205 @entity1863 @entity2008 @entity1499
@entity2008 detected at diagnosis are recognized as important in predicting response to chemotherapy in @entity3052 ( @entity3052 ). However, there is controversy concerning the prognostic significance of karyotype for outcome after allogeneic bone marrow transplantation (allo-BMT) performed in first complete remission ( @entity3432 ). This single-institution report describes allo-BMT for @entity3052 in @entity3432 and the effect of diagnostic cytogenetic findings on the results of that treatment. Between August 1981 and December 1999, 93 @entity1 underwent related donor (n = 82) or unrelated donor (n = 11) BMT. Conditioning and GVHD prophylaxis were achieved predominantly with @entity1863 and @entity786 and with @entity205 and @entity1499 , respectively. Seventy-nine (85%) of 93 @entity1 had successful marrow karyotyping at diagnosis, and the @entity1 were categorized into 3 prognostic groups based on the British Medical Research Council @entity3052 10 trial classification: 15 @entity1 (19%) were classified as having favorable risk [inv(16), t(8;2 1), t(15;17)]; 55 (70%) as having intermediate risk [no abnormality, +8, +21, +22, @entity6158 ), del(9q), 11q23 rearrangement, and other numerical or structural abnormalities]; and 9 (11%) as having adverse risk [-5, del(5q), -7, 3q rearrangements, > or = 5 abnormalities, t(6;9), t(9;22)]. The median follow-up was 93 months (range, 16-241 months). The overall survival (OS) rate, event-free survival (EFS) rate, relapse rate, and treatment-related mortality (TRM) were not statistically different between the groups. The 5-year actuarial EFS rates for favorable, intermediate, and adverse risk groups were 58% (95% confidence interval [CI], 29%-79%), 58% (95% CI, 43%-70%), and 67% (95% CI 28%-88%), respectively. Reclassification of @entity1 into cytogenetic prognostic subgroups according to Southwest Oncology Group criteria did not change these results. In univariate analysis, the only variable found to have a prognostic influence on OS (P = .04) and TRM (P = .03) was the type of donor (unrelated donor was linked to a worse prognosis), which was confirmed in multivariate analysis. Our study suggests that presentation karyotype has less prognostic significance for outcome following allo-BMT than for outcome following conventional chemotherapy. In particular, @entity3052 @entity1 with poor prognostic cytogenetic changes in @entity3432 who are unlikely to be cured with chemotherapy alone may benefit from allo-BMT.
