Abstract:
:The prognosis of acute myeloid leukemia (AML) is very poor in elderly patients, especially in those classically defined as having unfavorable cytogenetics. The recent monosomal karyotype (MK) entity, defined as 2 or more autosomal monosomies or combination of 1 monosomy with structural abnormalities, has been reported to be associated with a worse outcome than the traditional complex karyotype (CK). In this retrospective study of 186 AML patients older than 60 years, the prognostic influence of MK was used to further stratify elderly patients with unfavorable cytogenetics. CK was observed in 129 patients (69%), and 110 exhibited abnormalities according to the definition of MK (59%). MK(+) patients had a complete response rate significantly lower than MK(-) patients: 37% vs 64% (P = .0008), and their 2-year overall survival was also decreased at 7% vs 22% (P < .0001). In multivariate analysis, MK appeared as the major independent prognostic factor related to complete remission achievement (odds ratio = 2.3; 95% confidence interval, 1-5.4, P = .05) and survival (hazard ratio = 1.7; 95% confidence interval, 1.1-2.5, P = .008). In the subgroup of 129 CK(+) patients, survival was dramatically decreased for MK(+) patients (8% vs 28% at P = .03). These results demonstrate that MK is a major independent factor of very poor prognosis in elderly AML.
journal_name
Bloodjournal_title
Bloodauthors
Perrot A,Luquet I,Pigneux A,Mugneret F,Delaunay J,Harousseau JL,Barin C,Cahn JY,Guardiola P,Himberlin C,Recher C,Vey N,Lioure B,Ojeda-Uribe M,Fegueux N,Berthou C,Randriamalala E,Béné MC,Ifrah N,Witz F,Groupe Ouestdoi
10.1182/blood-2010-09-307264subject
Has Abstractpub_date
2011-07-21 00:00:00pages
679-85issue
3eissn
0006-4971issn
1528-0020pii
blood-2010-09-307264journal_volume
118pub_type
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