Impact of trisomy 19 on outcome according to genetic makeup in patients with acute myeloid leukemia

• Published in: Haematologica (Roma) Vol. 108; no. 8; pp. 2059 - 2066
• Main Authors: Kayser, Sabine, Martínez-Cuadrón, David, Rodriguez-Veiga, Rebeca, Hänel, Mathias, Tormo, Mar, Schäfer-Eckart, Kerstin, Botella, Carmen, Stölzel, Friedrich, Del Castillo, Teresa Bernal, Keller, Ulrich, Rodriguez-Medina, Carlos, Held, Gerhard, Amigo, Maria-Luz, Schliemann, Christoph, Colorado, Mercedes, Kaufmann, Martin, Garcia, Manuel Barrios, Krause, Stefan W, Görner, Martin, Jost, Edgar, Steffen, Björn, Zukunft, Sven, Platzbecker, Uwe, Ho, Anthony D, Baldus, Claudia D, Serve, Hubert, Müller-Tidow, Carsten, Thiede, Christian, Bornhäuser, Martin, Montesinos, Pau, Röllig, Christoph, Schlenk, Richard F
• Format: Journal Article
• Language: English
• Published: Italy Fondazione Ferrata Storti 01.08.2023; Ferrata Storti Foundation
• Subjects: Abnormal Karyotype; Acute Myeloid Leukemia; Child; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - therapy; Middle Aged; Remission Induction; Retrospective Studies; Trisomy - genetics
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2022.282127

We retrospectively studied 97 acute myeloid leukemia patients with trisomy 19 (median age at diagnosis 57 years; range, 17- 83 years) treated between 2001 and 2019 within two multicenter study groups. Trisomy 19 occurred alone in ten (10.5%) patients, with additional abnormalities being present in non-complex karyotypes in eight (8%) patients and in complex karyotypes in 79 (82%) patients. Altogether, karyotypes characterized by trisomies only were present in 27 (28%) patients. Data on response and outcome of intensively treated patients were available for 92 cases. The median follow-up was 6.4 years (95% confidence interval [95% CI]: 2.9-9.0 years). The complete remission (CR) rate after induction therapy was 52% (48 patients); the early death rate was 10% (n=9). Notably, patients with trisomy 19 as the sole abnormality had a CR rate of 89%. Allogeneic hematopoietic stem cell transplantation (allo-HCT) was performed in 34 (35%) patients (CR, n=19; active disease, n=15). Five-year relapse-free and overall survival rates were 26% (95% CI: 16-43%) and 20% (95% CI: 13-31%), respectively. Overall survival rates were significantly higher in patients with trisomy 19 as the sole abnormality or within karyotypes characterized by trisomies only (P=0.05). An Andersen-Gill model including allo-HCT as a time-dependent covariable on overall survival revealed that trisomy 19 as the sole abnormality or within karyotypes characterized by trisomies only was a favorable factor (hazard ratio [HR]=0.47; P=0.021); higher age at diagnosis had an adverse impact (10 years difference; HR=1.29; P=0.002), whereas allo-HCT did not have a beneficial impact (odds ratio=1.45; P=0.21). In our cohort, patients with trisomy 19 as the sole abnormality or within karyotypes characterized by trisomies only had a high CR rate and better clinical outcome.