Independent prognostic significance of day 21 cytogenetic findings in newly-diagnosed acute myeloid leukemia or refractory anemia with excess blasts

Background and Objectives. We investigated whether cytogenetic findings (CG) on day 21 (D21) of the first course of chemotherapy predicted subsequent outcome in patients who presented with CG abnormalities. Design and Methods. D21 CG analysis was performed in 197 patients. Results. Nineteen percent of the patients had exclusively abnormal metaphases (AA), 31% had only normal metaphases (NN), 39% had normal and abnormal metaphases (AN), and 11% had insufficient metaphases (0/0) on D21. A complete response was achieved in 79% of patients with NN, 60% with AN, 27% of those with AA, and 32% of those with 0/0. Interpretations and Conclusions. Disease-free survival in CR was longest in patients who had ≥1 normal metaphase on D21, with this finding being independent of D21 marrow and initial CG results. D21 CG can be used in therapeutic decision-making.