Monosomal karyotype in adult acute myeloid leukemia: prognostic impact and outcome after different treatment strategies.

Abstract:

:We aimed to determine the prognostic impact of monosomal karyotype (MK) in acute myeloid leukemia (AML) in the context of the current World Health Organization (WHO) classification and to evaluate the outcome of MK(+) patients after allogeneic HSCT. Of 1058 patients with abnormal cytogenetics, 319 (30%) were MK MK(+). MK(+) patients were significantly older (P = .0001), had lower white blood counts (P = .0006), and lower percentages of BM blasts (P = .0004); MK was associated with the presence of -5/5q-, -7, 7q-, abnl(12p), abnl(17p), -18/18q-, -20/20q-, inv(3)/t(3;3), complex karyotype (CK), and myelodysplasia (MDS)-related cytogenetic abnormalities (P < .0001, each); and NPM1 mutations (P < .0001), FLT3 internal tandem duplications (P < .0001), and tyrosine kinase domain mutations (P = .02) were less frequent in MK(+). Response to induction therapy and overall survival in MK(+) patients were dismal with a complete remission rate of 32.5% and a 4-year survival of 9%. MK retained its prognostic impact in AML with CK, AML with MDS-related cytogenetic abnormalities, and in a revised definition (MK-R) excluding cases with recurrent genetic abnormalities according to WHO classification and those with derivative chromosomes not leading to true monosomies. In younger patients, allogeneic HSCT from matched related and unrelated donors resulted in a limited improvement of overall survival.

journal_name

Blood

journal_title

Blood

authors

Kayser S,Zucknick M,Döhner K,Krauter J,Köhne CH,Horst HA,Held G,von Lilienfeld-Toal M,Wilhelm S,Rummel M,Germing U,Götze K,Nachbaur D,Schlegelberger B,Göhring G,Späth D,Morlok C,Teleanu V,Ganser A,Döhner H,Schlenk

doi

10.1182/blood-2011-07-367508

subject

Has Abstract

pub_date

2012-01-12 00:00:00

pages

551-8

issue

2

eissn

0006-4971

issn

1528-0020

pii

blood-2011-07-367508

journal_volume

119

pub_type

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