Background Therapy-related AML (t-AML) occurs as a late complication of chemotherapy administered to treat a prior disorder. studies have reported that karyotype is an impartial prognostic parameter in t-AML, these studies focused only on cytogenetic abnormalities and did not include molecular aberrations, Danusertib cytotoxic therapy regimens, or hemograms as prognostic indicators [10-12]. Additionally, a recently published paper examined clinical and cytogenetic characteristics of 39 patients diagnosed Danusertib with therapy-related myeloid neoplasms from a single center, but this study did not focus on t-AML nor the prognostic factors [13]. In Danusertib this study, we performed a comprehensive evaluation to identify the impartial prognostic factors in t-AML. MATERIALS AND METHODS Patient selection and treatment A total of 48 t-AML patients were recognized in a retrospective, systematic review of electronic medical records of patients diagnosed with AML at Asan Medical Center, Seoul, Korea from January 2001 to December 2011. All patients received induction chemotherapy consisting of cytarabine and daunorubicin. The therapeutic regimen included continuous intravenous infusion of 200 mg/mL per day (100 mg/mL per day for patients aged >60 years of age) of cytarabine from day 1 to day 7, and 45 mg/mL per day of daunorubicin from day 1 to day 3. Total remission (CR) was defined as the presence of less than 5% blasts with >20% cellularity in a bone marrow (BM) aspirate after induction chemotherapy. Relapse was defined as the presence of more than 5% leukemic blasts in bone marrow aspirates in patients with a previous CR state. Relapsed patients received the same induction chemotherapy regimen as that used at initial diagnosis. Depending on the patient’s age and the availability of a suitable donor, patients received allogeneic stem cell transplantation (SCT) as close to the time of CR status confirmation as you possibly can. Patient classification and comparison of clinical presentation The 48 t-AML patients were categorized into 4 groups according to chemotherapeutic regimen: AK only (5 patients), AK and TI (21 patients), TI only (9 patients), as well as others (13 patients). Clinical data for gender, age, French-American-British (FAB) phenotype, hemogram results, ITD mutation status, karyotype, CR rate, relapse rate, death rate, and date of allogeneic SCT were compared among the 4 individual groups. Patients who were classified as having chromosome 5/7 or 11/21 abnormalities were included in the chromosome 5/7 or 11/21 abnormality group, regardless of whether the patient experienced a complex karyotype or not. Similarly, patients were categorized into 2 groups with respect to the presence of a complex karyotype, irrespective of which, if any, chromosomal abnormality was present. From these data, we calculated the prognostic markers, overall survival (OS), and disease-free survival (DFS). OS was defined as the time from diagnosis to death or, alternatively, last follow-up. DFS was defined as the time from Danusertib CR to relapse for patients who experienced a relapse, death for non-relapsed patients who did not survive, or the time of the last follow-up for surviving patients who did not experience a relapse. If the patients received allogeneic SCT, the initial CR date for the calculation of DFS was replaced by the SCT date. Comparison of prognosis The impact of clinical variables on OS and DFS was Rabbit Polyclonal to 5-HT-3A evaluated separately. Variables included in the analysis were chemotherapy regimens, BM blast percentage, ITD mutation status, presence of chromosome 5/7 or 11/21 abnormalities, presence of a complex karyotype, presence of a FAB M3 phenotype, and overall performance status of allogeneic SCT. The BM blast cell percentage comparison of prognosis was analyzed using the median value of BM blasts (61.1%) Danusertib as a cutoff for the differentiation of 2 groups. Multivariate analysis was performed to confirm variables that experienced a significant impartial prognostic impact during univariate analysis. Age, BM blasts, overall performance status of allogeneic SCT, ITD mutation status, presence of chromosome 5/7 abnormalities, presence of a complex karyotype, and FAB M3 phenotype were included as covariables in the multivariate analysis. Statistical analysis Pearson chi-square or Fisher’s exact tests were used to compare categorical variables with respect to the 4 chemotherapy groups. The Kruskal-Wallis test was used to compare continuous variables with respect to the 4 chemotherapy groups. Estimates of survival.