The coexisting presence of 2 or more additional chromosomal abnormalities (ACAs) in patients with chronic myelogenous leukemia (CML) was linked with inferior survival and was categorized into a poor prognostic group, according to a study published in Blood.1
Clonal cytogenetic evolution with ACAs is typically linked with decreased response to tyrosine kinase inhibitor therapy and worse survival. The presence of ACAs indicates disease progression and is used as part of the criteria for accelerated phase.
There is no classification system for prognostic indication of individual ACAs, thus study investigators sought to address the prognostic impact using a large cohort of patients with CML treated with tyrosine kinase inhibitors.
Investigators examined cases in patients that had 1 chromosomal change at the time of ACA emergence and stratified the 6 most common ACAs into 2 groups: group 1 included those with a relatively good prognosis including trisomy 8, -Y, and an extra copy of Philadelphia chromosome; group 2 included those with with a relatively poor prognosis including i(17)(q10), -7/7q (-7/del7q), and 3q26.2 rearrangements.
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Results showed that patients in group 1 had better treatment response and survival than those in group 2. When compared to cases with no ACAs, ACAs in group 2 had a worse survival irrelevant to the emergence phase and time. However, ACAs in group 1 had no adverse impact on survival when they emerged from chronic phase or at the time of diagnosis.
- Wang W, Cortes JE, Tang G, et al. Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy [published online ahead of print March 22, 2016]. Blood. doi: 10.1182/blood-2016-01-690230.