Introduction Trisomy 21 (+21) is frequently noted in patients with acute myeloid leukemia (AML). Time to progression (TTP) was 12 months (range, 5C19) and overall survival (Operating-system) was 9 weeks (range, 7C11) for the whole group. TTP was much longer for individuals with +21 only (not really reached) or with +21 with beneficial MLN8054 cytogenetics (101 weeks) when compared with people that have +21 with intermediate cytogenetics (2 weeks) or +21 with unfavorable cytogenetics (11 weeks) (= 0.02). Likewise, Operating-system was improved in individuals with +21 with beneficial cytogenetics (not really reached) or +21 only (107 weeks), when compared with +21 with unfavorable cytogenetics (9 weeks) or +21 with intermediate cytogenetics (8 weeks) (< 0.001). The variations in TTP and Operating-system were taken care of on multivariate evaluation (= 0.04 and = 0.001; respectively) Conclusions Isolated +21/+21 with beneficial aberrations hitherto categorized as intermediate-risk cytogenetics could possibly work as a favorable-risk cytogenetics in adult AML individuals. ideals had been considered and 2-sided significant if add up to or significantly less than 0.05. Results Research group A complete of ninety individuals harbored +21 either as an isolated aberration or in conjunction with additional cytogenetic aberrations. The baseline affected person characteristics of the individuals are demonstrated in desk MLN8054 1. The median age group was 59 (range, 18C88) years. All individuals received preliminary therapy for AML at MDACC. Median white bloodstream cell count, peripheral bloodstream blast percentage and bone tissue marrow blast percentage at demonstration had been 4.6 109/L (range, 0.6C190), 17% (0C96) and 48% (0C97), respectively. The majority of patients had a FAB M0-M2 (64%) phenotype. Karyotype was +21 alone in 11 patients (12%), +21 with favorable cytogenetic aberrations in 7 patients (8%), +21 with intermediate aberrations in 7 patients (8%) and +21 with unfavorable aberrations in 65 patients (72%). Table 1 Patients Characteristics (N = 90) Response characteristics The most frequently administered induction regimen was IA which was used in 36% of the patients, followed by FLU in 24%, CLO and HMT in 11% each, CAT in 10% and MISC in 8% of the patients (table 2). Forty-five (50%) patients achieved a CR, 4 (4%) achieved CRp, 30 (33%) were MLN8054 non-responders (NR) and 11 (13%) died during induction therapy. No significant differences in CR/CRp rate were observed according to the induction routine (= 0.37) or +21 cytogenetic subgroup (= 0.057). Nevertheless, there is a tendency to improved CR/CRp prices in individuals with +21 only or +21 with beneficial cytogenetics when compared with people that have +21 with intermediate cytogenetics or +21 MLN8054 with unfavorable cytogenetics (76% versus 50%; = 0.057) (desk 3). From the 49 individuals that accomplished a CR/CRp, 21 individuals (43%) proceeded to allogeneic stem cell transplantation. Desk 2 Response by induction regimen (N = 90) Desk 3 Response by cytogenetic subgroup (N = 90) Results Among the 49 individuals who accomplished a CR, median TTP was 12 (range, 5C19) weeks (Fig 1A). TTP was considerably longer for individuals with +21 only (not really reached) or with +21 with beneficial cytogenetics (101 weeks) when compared with those with +21 with intermediate cytogenetics (2 months) or +21 with unfavorable cytogenetics (11 months) (= 0.02) (Fig 1B). On multivariate COX regression patients with +21 alone maintained an improved TTP as compared to patients with +21 with intermediate cytogenetics or patients with +21 with unfavorable cytogenetics (= 0.04). Covariates assessed included white blood cells, peripheral blasts, previous hematological malignancies, performance status, age, treatment with SCT, and induction therapy (Fig 1C). Figure 1 (A) Median time to progression (TTP) for the 49 patients that achieved complete remission after induction therapy (B) Median TTP for the 49 patients that achieved complete remission according to cytogenetic subgroup (C) Median TTP for the 49 patients … Median OS for all patients was 9 (range, 7C11) months (Fig 2A). OS Ppia was significantly longer in patients with +21 with favorable cytogenetics (not reached) or +21 alone (107 MLN8054 months), as compared to +21 with unfavorable cytogenetics (9 months) or +21.