Browsing by Author "Sun, Zhuoxin"

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    Independent Prognostic Significance of Monosomy 17 and Impact of Karyotype Complexity in Monosomal Karyotype/Complex Karyotype Acute Myeloid Leukemia: Results from Four ECOG-ACRIN Prospective Therapeutic Trials
    (Elsevier, 2017-08) Strickland, Stephen A.; Sun, Zhuoxin; Ketterling, Rhett P.; Cherry, Athena M.; Cripe, Larry D.; Dewald, Gordon; Fernandez, Hugo; Hicks, Gary A.; Higgins, Rodney R.; Lazarus, Hillard M.; Litzow, Mark R.; Luger, Selina M.; Paietta, Elisabeth M.; Rowe, Jacob M.; Vance, Gail H.; Wiernik, Peter; Wiktor, Anne E.; Zhang, Yanming; Tallman, Martin S.; Department of Medicine, IU School of Medicine
    The presence of a monosomal karyotype (MK+) and/or a complex karyotype (CK+) identifies subcategories of AML with poor prognosis. The prognostic significance of the most common monosomies (monosomy 5, monosomy 7, and monosomy 17) within MK+/CK+ AML is not well defined. We analyzed data from 1,592 AML patients age 17–93 years enrolled on ECOG-ACRIN therapeutic trials. The majority of MK+ patients (182/195; 93%) were MK+/CK+ with 87% (158/182) having ≥5 clonal abnormalities (CK≥ 5). MK+ patients with karyotype complexity ≤4 had a median overall survival (OS) of 0.4y compared to 1.0y for MK- with complexity ≤4 (p < 0.001), whereas no OS difference was seen in MK+ vs. MK- patients with CK≥ 5 (p = 0.82). Monosomy 5 (93%; 50/54) typically occurred within a highly complex karyotype and had no impact on OS (0.4y; p = 0.95). Monosomy 7 demonstrated no impact on OS in patients with CK≥ 5 (p = 0.39) or CK ≤ 4 (p = 0.44). Monosomy 17 appeared in 43% (68/158) of CK≥ 5 patients and demonstrated statistically significant worse OS (0.4y) compared to CK≥ 5 patients without monosomy 17 (0.5y; p = 0.012). Our data suggest that the prognostic impact of MK+ is limited to those with less complex karyotypes and that monosomy 17 may independently predict for worse survival in patients with AML.
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    Integrative analysis identifies an older female-linked AML patient group with better risk in ECOG-ACRIN Cancer Research Group's clinical trial E3999
    (Springer Nature, 2022-09-23) Rapaport, Franck; Seier, Kenneth; Neelamraju, Yaseswini; Hassane, Duane; Baslan, Timour; Gildea, Daniel T.; Haddox, Samuel; Lee, Tak; Murdock, H. Moses; Sheridan, Caroline; Thurmond, Alexis; Wang, Ling; Carroll, Martin; Cripe, Larry D.; Fernandez, Hugo; Mason, Christopher E.; Paietta, Elisabeth; Roboz, Gail J.; Sun, Zhuoxin; Tallman, Martin S.; Zhang, Yanming; Gönen, Mithat; Levine, Ross; Melnick, Ari M.; Kleppe, Maria; Garrett-Bakelman, Francine E.; Medicine, School of Medicine
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    Prognostic effect of gender on outcome of treatment for adults with acute myeloid leukaemia
    (Wiley, 2021) Wiernik, Peter H.; Sun, Zhuoxin; Cripe, Larry D.; Rowe, Jacob M.; Fernandez, Hugo F.; Luger, Selina M.; Lazarus, Hillard M.; Paietta, Elisabeth M.; Tallman, Martin S.; Litzow, Mark R.; Medicine, School of Medicine
    There are conflicting reports in the literature suggesting that one gender or the other has a better survival with acute myeloid leukaemia (AML). This study was done in an attempt to resolve the issue. The effect of gender was examined on 3,546 newly diagnosed patients with AML, including 548 patients with acute promyelocytic leukaemia (APL) enrolled in 10 multi-institutional treatment studies from March 1984 to November 2008. Kaplan-Meier estimates were used to estimate event-time distributions for survival and multivariate models were used to examine the gender effect after adjusting for multiple risk factors. P values were based on 2-sided tests. Non-APL female patients had a significantly better overall but not disease-free survival than males, irrespective of age, initial WBC count, or dose of daunorubicin. No differences were observed for obese or FLT3-ITD + patients. Female APL patients had a significantly better overall and disease-free survival than male APL patients, and differences in survival were greater for patients with t(15;17) + other cytogenetic abnormalities compared with those with t(15;17) only. Gender is an independent prognostic variable in patients with AML. Whether these survival differences are due to hormonal, genetic or pharmacokinetic differences between the sexes, or differential toxin exposure such as smoking is unknown. However, the former seems less likely since patient age did not influence the survival advantage for female patients.