Cytogenetic Studies and Their Clinical Correlates in Adults with Acute Leukemia

Cytogenetic studies were performed in 95 adults with acute leukemia, 39 (41%) of whom had abnormal karyotypes in their leukemic cells. The karyotypes were grouped according to the Denver-Chicago classification, and abnormalities were correlated with clinical variables. The frequency and quality of abnormality was not influenced by age, morphologic type of leukemia, or prior treatment. The frequency of abnormal karyotypes was increased in patients with increasing leukocytosis. Hypodiploidy adversely affected response to treatment and survival. D or E group chromosome deletions were associated with a decreased response to treatment and survival, whereas patients with extra D or E chromosomes had an improved prognosis. The overall distribution of chromosomal abnormalities in the leukemic cells deviated significantly from the expected for random distribution. D+, E+, and G — abnormalities were significantly more frequent than expected. Patients with marrow leukemic cell aneuploidy showed a loss of their abnormality during complete remission and recurrence at the time of relapse. The evidence suggested that chromosomal aberrations occur with increasing frequency as patients approach death. CYTOGENETIC ABNORMALITIES are present in the leukemic cells of 40% to 60% of patients with acute leukemia (1). Although these chromosomal alterations tend to remain constant within a given patient, it has generally been considered that there are no specific abnormalities that characterize the disease (2-4). This contrasts with chronic granu­ locytic leukemia, where most patients have a specific and characteristic cytogenetic abnormality,