Chromosomal Abnormalities Signal CNS Involvement in AML

Wednesday, December 28, 2011 (Last Updated: 12/29/2011)

WEDNESDAY, Dec. 28 (HealthDay News) -- Cytogenetic analysis at the time of diagnosis in patients with acute myeloid leukemia (AML) shows higher rates of chromosomal abnormalities for patients with central nervous system (CNS) involvement than for those with no CNS involvement, and survival is typically poor for patients with AML and CNS disease, according to a study published in the Jan. 1 issue of Cancer.

Ferial Shihadeh, M.D., of The University of Texas M.D. Anderson Cancer Center in Houston, and colleagues investigated whether cytogenetic findings can predict CNS involvement in AML. In a retrospective review of 1,354 records of patients with AML, 40 patients (3 percent) had CNS involvement at the time of presentation or disease recurrence. CNS disease was diagnosed by magnetic resonance imaging, cerebrospinal fluid examination, or both. Primary CNS symptoms included headaches, cranial nerve palsies, and motor deficits. Bone marrow cytogenetic profiles were available for 37 of the 40 patients with CNS involvement.

Compared with patients who had AML with no CNS involvement, the researchers found that patients with CNS disease exhibited a higher rate of chromosome 16 inversion (16 versus 4 percent), chromosome 11 abnormality (12.5 versus 3.7 percent), and trisomy 8 (12 versus 7 percent); the rate of complex cytogenetics did not significantly differ between the groups (38 versus 26 percent). The subgroup of patients with AML who exhibited CNS involvement tended to be younger and had a higher white blood cell count, higher lactate dehydrogenase levels, and a higher percentage of peripheral blast cells at diagnosis.

"Our study can serve as a descriptive study of what may predispose patients with AML to develop CNS disease. Confirmation of our results by other groups is important. At this time and in view of the low incidence of CNS disease (3 percent), it would not be reasonable to make any therapeutic changes to patients who present with these risk factors, but such patients may warrant close evaluation and follow-up for CNS disease," the authors write.

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Specialties Hematology & Oncology

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