Relevance of the Cytogenetic Status in Acute Leukemia in Adults2

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Abstract
In 79 adults with acute leukemia, cytogenetic studies of the blood and marrow were made to assess their relationship to the patients' clinical condition. Of the patients, 30.4% had abnormal cell lines and 69.6%, only diploid ones. In 75% of the patients with abnormal lines, varying proportions of diploid cells were also present. Seventy-three patients were treated subsequent to the initial studies, and in 63% of them serial (2–21) cytogenetic examinations were done. Remissions occurred in 35% of the treated patients with abnormal lines and in 48% of those with only diploid cells. The difference in remission rates was not statistically significant. There was a significant tendency to deletions of G-group chromosomes in the group of patients with cytogenetic abnormalities. However, neither this nor any other specific chromosome abnormality had a significant relationship to the likelihood of remission induction, and neither had the nature of the ploidy (hyperdiploidy, pseudodiploidy, or hypodiploidy). Diploid cells completely replaced abnormal lines in 6 of 8 initially aneuploid patients entering remission. Multiple serial specimens confirmed that 100% diploidy persisted throughout the remission periods, with return of the original abnormal clones in terminal relapse. The Frequent finding of mixtures of diploid with aneuploid or pseudodiploid cell populations in untreated patients and of the disappearance of abnormal cells during remission supports the view that improved therapeutic methods aimed at the eradication of leukemic cells may lead to better clinical results.

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