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It allows stratification of AML patients into subgroups with distinct responses to therapy and survival. Unfortunately, a variety of issues hamper cytogenetic evaluation in c.?10% of cases [unsuccessful cytogenetics (UC)] and the outcome of these patients is poorly understood. To better define the significance of UC in patients with AML, we compared the baseline characteristics http://www.selleckchem.com/products/PD-0325901.html and the prognostic impact of 94 (6%) patients, whose standard metaphase analysis yielded unacceptable results, to the remaining 1403 AML patients with successful cytogenetic analysis treated on successive Southwestern Oncology Group protocols. The incidence of UC increased with age, with peak incidence in patients older than 60?years. These patients had a lower response rate to induction chemotherapy (complete remission rate of 43%) and dismal 5-year survival rates (16%), which was especially poor in patients older than 60?years ( http://www.selleck.cn/products/JNJ-26481585.html of the leukaemic clone in tissue culture, insufficient number of metaphase http://www.selleckchem.com/products/epz-6438.html cells, reduced cell viability or hypocellularity upon arrival to the reference laboratory, poor chromosome morphology or complexity of the karyotype (Fischer et?al, 1996). Unsuccessful karyotyping may also reflect intrinsic biological properties of the leukaemic clone that may be otherwise difficult to ascertain and that could reveal valuable prognostic features in these patients. Previous studies have demonstrated that the rate of unsuccessful karyotyping in patients with AML is approximately 10% (Fischer et?al, 1996; Grimwade et?al, 2010). We determined the characteristics of AML patients with unsuccessful cytogenetics (UC) and investigated its prognostic significance in AML patients treated on Southwestern Oncology Group (SWOG) clinical trials. We used data from 1623 patients with previously untreated AML registered between 1986 and 2009 in 1 of 10 successive SWOG clinical trials (S8600, S9031, S9034, S9126, S9333, S9500, S9617, S9918, S0106, and S0112) (Medeiros et?al, 2010). Centrally reviewed cytogenetic data from diagnosis were used. Patients were classified into one of three categories: normal, abnormal or UC. A result was regarded as normal karyotype only after successful analysis of 20 or more normal metaphases.