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Abnormal chromosomes forecast leukemia relapse

COLUMBUS, Ohio Patients with acute myeloid leukemia (AML) who enter remission with abnormal chromosomes in bone marrow cells are twice as vulnerable to recurrence of their disease as are AML patients with normal bone marrow cells at remission, according to a new study.

The findings by researchers at The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute call for routine testing for chromosomal abnormalities in AML patients at diagnosis and again when patients enter remission.

If verified, the findings mean that AML patients showing chromosomal abnormalities early during remission should be considered for more intensive treatment, such as a bone marrow transplant, in an attempt to prevent a return of the disease. Patients with normal-looking chromosomes can receive standard therapy.

The findings are published in the June 15 issue of the Journal of Clinical Oncology.

"For the first time, we have shown in a relatively large group of patients that someone with AML who has abnormal chromosomes early during remission will relapse, even if blood counts and other parameters are favorable," says first author Guido Marcucci, associate professor of internal medicine and a hematologist/oncologist with OSU's James Cancer Hospital.

Since 1990, physicians have said that AML patients were in complete remission following treatment if their blood count was normal, and their bone marrow contained fewer than 5 percent of immature cells known as blasts.

By that definition, 60 percent to 70 percent of AML patients achieve complete remission, but only 30 percent to 40 percent of those patients remain in remission long enough to be considered completely cured of their disease.

"Achieving complete remission is an important step for a successful treatment," Marcucci says, "but it does not predict who will do well in the long run and who will relapse. We need
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Contact: Darrell E. Ward
Ward-15@medctr.osu.edu
614-293-3737
Ohio State University
16-Jun-2004


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