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Mutation analysis of metaphase cells is essential in the evaluation of patients with acute myeloid leukemia (AML). Specific cytogenetic abnormalities permit subdivision of patients with AML into favorable, intermediate, or unfavorable-risk groups. Thus, the type of AML will define diagnostic approaches, prognostic factors, and possible therapy options for each patient.
In a Letter to the Editor of the American Journal of Hematology, Kebede H. Begna, and colleagues from the Mayo Clinic, Rochester, MN, USA, reported results of a study evaluating the prognostic value of cytogenetic and FLT3-ITD/NPM1 mutation information. The research group established a risk model to identify genetic and clinical variables as well as possible specific treatment strategies.
Three hundred and eighty AML patients (median age = 63 years, range 21–89) with intermediate risk (n = 273; 72%) and adverse risk (n = 107; 28%) karyotype and with available FLT3-ITD and NPM1 mutation information were included in this study.
Taken together, this study indicates that for patients with AML without favorable karyotype achieving CR or CRi is mandatory for long-term remission. CR/CRi was achieved only in patients treated with intensive chemotherapy and thus survival outcomes were not significantly different between CR and CRi rates.
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