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Favorable cytogenetics t(8;21)

inv 16 or t(16;16) t(15;17)

2.0% 3.4% 4.0%

9.4% 10.4% 6-12%

Unfavorable cytogenetics

Complex

9.1% 6.2% 18.3%

3.2% 4.0% 7.1%

MDR1 expression

71%

35%

Secondary AML

24-56%

8%

Treatment-related mortalityc

25-30%

5-10%

Complete remissionc

39-61%

65-73%

Long-term disease-free survivalc

5-15%

30%

a In general, older AML patients are defined as 60 years of age or older and younger AML patients as below 60 years of age. b New diagnoses, per 100,000 US citizens per year. Older/younger division occurs at 65 years.

c Rates following remission induction therapy with an anthracycline-or anthracenedione-based regimen.

Reprinted from Stone RM, O'Donnell MR, Sekeres MA: Acute myeloid leukemia. Hematology Am Soc Hematol Educ Program 98-117, 2004, copyright American Society of Hematology, U.S.A.

a In general, older AML patients are defined as 60 years of age or older and younger AML patients as below 60 years of age. b New diagnoses, per 100,000 US citizens per year. Older/younger division occurs at 65 years.

c Rates following remission induction therapy with an anthracycline-or anthracenedione-based regimen.

Reprinted from Stone RM, O'Donnell MR, Sekeres MA: Acute myeloid leukemia. Hematology Am Soc Hematol Educ Program 98-117, 2004, copyright American Society of Hematology, U.S.A.

of AML patients over the age of 55 years. Compare this to an incidence of 35% in younger AML patients.21'22 MDRl/p-glycoprotein expression is associated with lower complete remission (CR) rates and more chemore-sistant disease. In addition, defects in the MSH2 protein involved in DNA mismatch repair and genome protection are expressed with greater frequency in this population.20 Abnormalities of DNA mismatch repair due to defective MSH2 expression could play a key role in leukemogenesis, in particular in AML arising in older patients or secondary to previous chemotherapy.

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