Prognostic significance of chromosomal abnormalities in acute leukaemias and myelodysplastic syndromes.

The main purpose of this review is to emphasize the critical role that chromosome analysis can play in the diagnosis, prognosis and management of blood malignancies. Table 3 shows that most patients with AML, MDS and ALL can be placed into one of three major prognostic categories. When chromosome analysis is combined with a cytological study in AML and MDS and with a cytological and immunophenotypic study in ALL, the clinical value of such analysis is further enhanced. Because of critical prognostic information that may be obtained primarily from refined chromosome analysis, we recommend that a major effort be undertaken to develop capability for such analysis in all large institutions so that the information derived can be used routinely in the assessment of haematological malignancies. In particular, it is now necessary to reassess the value of current treatments taking into consideration refined chromosome studies. We believe that patients within specific chromosomal categories should be treated with specific types of therapy in an attempt to improve overall survival.