@article{Christian Niederwieser_Deedra Nicolet_Andrew J. Carroll_Jonathan E. Kolitz_Bayard L. Powell_Jessica Kohlschmidt_Richard M. Stone_John C. Byrd_Krzysztof Mrózek_Clara D. Bloomfield_2016, place={Pavia, Italy}, title={Chromosome abnormalities at onset of complete remission are associated with worse outcome in patients with acute myeloid leukemia and an abnormal karyotype at diagnosis: CALGB 8461 (Alliance)}, volume={101}, url={https://haematologica.org/article/view/7908}, DOI={10.3324/haematol.2016.149542}, abstractNote={Achievement of complete remission is essential for long-term survival of acute myeloid leukemia patients. We evaluated the prognostic significance of cytogenetics at complete remission in 258 adults with <em>de novo</em> acute myeloid leukemia and abnormal pre-treatment karyotypes, treated on Cancer and Leukemia Group B front-line studies, with cytogenetic data at onset of morphological complete remission. Thirty-two patients had abnormal karyotypes at time of initial complete remission. Of these, 28 had at least 1 abnormality identified pre-treatment, and 4 acute myeloid leukemia-related abnormalities not detected pre-treatment. Two hundred and twenty-six patients had normal remission karyotypes. Patients with abnormal remission karyotypes were older (<em>P</em><0.001), had lower pre-treatment white blood counts (<em>P</em>=0.002) and blood blast percentages (<em>P</em>=0.004), were less often classified as Favorable and more often as Adverse among European LeukemiaNet Genetic Groups (<em>P</em><0.001), and had shorter disease-free survival (median 0.6 <em>vs.</em> 0.9 years; <em>P</em><0.001) and overall survival (median 1.2 <em>vs.</em> 2.2 years; <em>P</em><0.001) than patients with normal remission karyotypes. Sixteen patients with normal remission karyotypes also harbored non-clonal abnormalities unrelated to pre-treatment karyotypes. They had shorter overall survival than 210 patients with only normal metaphases (<em>P</em>=0.04). Forty-eight patients with any clonal or non-clonal chromosome abnormality at complete remission had worse disease-free survival (median 0.6 <em>vs.</em> 1.0 years; <em>P</em><0.001) and overall survival (median 1.2 <em>vs.</em> 2.5 years; <em>P</em><0.001) than 210 patients with exclusively normal metaphases. In multivariable analyses, after adjustment for age, the presence of any remission abnormality was associated with shorter disease-free survival (<em>P</em>=0.03) and overall survival (<em>P</em>=0.01). We conclude that detection of any abnormality at complete remission is an adverse prognostic factor. (<em><a href="http://clinicaltrials.gov">clinicaltrials.gov</a> identifier: 00048958</em&gt;)}, number={12}, journal={Haematologica}, author={Christian Niederwieser and Deedra Nicolet and Andrew J. Carroll and Jonathan E. Kolitz and Bayard L. Powell and Jessica Kohlschmidt and Richard M. Stone and John C. Byrd and Krzysztof Mrózek and Clara D. Bloomfield}, year={2016}, month={Nov.}, pages={1516-1523} }