Cariótipo em leucemia mielóide aguda: importância e tipo de alteração em 30 pacientes ao diagnóstico

Luís Arthur Flores Pelloso, Maria de Lourdes Lopes Ferrari Chauffaille, Fabiana Sinnot Ghaname, Mihoko Yamamoto, Daniella Márcia Maranhão Bahia, José Kerbauy

Cytogenetics in AML at diagnosis is a well defined prognostic tool. The authors analized karyotype (KT) and clinical data of newly diagnosed AML patients. Thirty patients were studied, 16 male and 14 female. Age ranged from 19 to 84 years. Diagnostic criteria were based on WHO classification, immunophenotyping and G banding cytogenetics. They were treated according to standard protocol (daunorrubicin and cytarabine - 3+7) and those who had Acute Promyelocytic Leukemia additionally received ATRA. KT success rate was 84%. According to KT patients were divided into 4 groups: favourable prognosis (FP) (6) (t(8;21), t(15;17)); intermediary prognosis (IP) (7)(four normal karyotypes, + 8, t(1;2) and del 18(q)); unfavourable prognosis (UP); and 3 secondary AML; two evolving from prior Mylelodysplastic Syndrome and one presenting as an initial blast crisis of chronic myeloid leukemia. The median age of FP was 23 years while UP was 60 years (p<0.003). In the FP, 5/6 (83%) achieved complete remission (CR) while only 1/7 (20%)in the IP and 1/8 (12,5%) in the UP. There was a tendency of higher leukocyte count in the unfavourable group. The rate of karyotype aberrations in AML was 80% and in accordance to literature data (65-95%). There was a clear difference in CR rates between favourable and unfavourable prognosis group.