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Telomerase activity is prognostic in pediatric patients with acute myeloid leukemia
Comparison with adult acute myeloid leukemia
Article first published online: 17 APR 2003
Copyright © 2003 American Cancer Society
Volume 97, Issue 9, pages 2212–2217, 1 May 2003
How to Cite
Verstovsek, S., Manshouri, T., Smith, F. O., Giles, F. J., Cortes, J., Estey, E., Kantarjian, H., Keating, M., Jeha, S. and Albitar, M. (2003), Telomerase activity is prognostic in pediatric patients with acute myeloid leukemia. Cancer, 97: 2212–2217. doi: 10.1002/cncr.11313
- Issue published online: 17 APR 2003
- Article first published online: 17 APR 2003
- Manuscript Accepted: 7 JAN 2003
- Manuscript Revised: 30 DEC 2002
- Manuscript Received: 12 SEP 2002
- telomerase activity;
- pediatric acute myeloid leukemia (AML);
- adult acute myeloid leukemia;
Significantly elevated telomerase activity (TA) has been found in samples from patients with almost all malignant hematologic diseases. The impact of elevated TA on the course of pediatric patients with acute myeloid leukemia (P-AML) is unknown.
Using a modified polymerase chain reaction-based, telomeric repeat-amplification protocol assay, the authors measured TA in bone marrow samples from 40 patients with P-AML and, for comparison, in 65 adult patients with AML (A-AML), excluding patients with French–American–British M3 disease. The results were correlated with patient characteristics and survival.
TA in patients with P-AML was significantly lower compared with TA in patients with A-AML (P = 0.005). Patients who had P-AML with low TA had a projected 5-year survival rate of 88%, whereas patients who had P-AML with high TA had a projected 5-year survival rate of 43% (P = 0.009). Conversely, patients who had A-AML with very high TA (upper quartile) had significantly longer survival compared with patients who had A-AML with lower TA (P = 0.03). There was no correlation between complete remission rate or disease free survival and TA in P-AML or A-AML. In the A-AML group, when patients were separated by cytogenetic findings (poor prognosis vs. others), it was found that TA was significantly lower in patients with a poor prognosis, but the prognostic value of TA was not independent of cytogenetic status.
The current results suggest, that for patients with P-AML, bone marrow TA is a highly significant prognostic factor. Cancer 2003;97:2212–7. © 2003 American Cancer Society.