Monosomal karyotype in acute myeloid leukemia: a better indicator of poor prognosis than a complex karyotype.

Details

Serval ID
serval:BIB_9D3A7D70C3CB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Monosomal karyotype in acute myeloid leukemia: a better indicator of poor prognosis than a complex karyotype.
Journal
Journal of Clinical Oncology
Author(s)
Breems D.A., Van Putten W.L., De Greef G.E., Van Zelderen-Bhola S.L., Gerssen-Schoorl K.B., Mellink C.H., Nieuwint A., Jotterand M., Hagemeijer A., Beverloo H.B., Löwenberg B.
ISSN
1527-7755[electronic]
Publication state
Published
Issued date
2008
Volume
26
Number
29
Pages
4791-4797
Language
english
Abstract
PURPOSE: To investigate the prognostic value of various cytogenetic components of a complex karyotype in acute myeloid leukemia (AML). PATIENTS AND METHODS: Cytogenetics and overall survival (OS) were analyzed in 1,975 AML patients age 15 to 60 years. RESULTS: Besides AML with normal cytogenetics (CN) and core binding factor (CBF) abnormalities, we distinguished 733 patients with cytogenetic abnormalities. Among the latter subgroup, loss of a single chromosome (n = 109) conferred negative prognostic impact (4-year OS, 12%; poor outcome). Loss of chromosome 7 was most common, but outcome of AML patients with single monosomy -7 (n = 63; 4-year OS, 13%) and other single autosomal monosomies (n = 46; 4-year OS, 12%) did not differ. Structural chromosomal abnormalities influenced prognosis only in association with a single autosomal monosomy (4-year OS, 4% for very poor v 24% for poor). We derived a monosomal karyotype (MK) as a predictor for very poor prognosis of AML that refers to two or more distinct autosomal chromosome monosomies (n = 116; 4-year OS, 3%) or one single autosomal monosomy in the presence of structural abnormalities (n = 68; 4-year OS, 4%). In direct comparisons, MK provides significantly better prognostic prediction than the traditionally defined complex karyotype, which considers any three or more or five or more clonal cytogenetic abnormalities, and also than various individual specific cytogenetic abnormalities (eg, del[5q], inv[3]/t[3;3]) associated with very poor outcome. CONCLUSION: MK enables (in addition to CN and CBF) the prognostic classification of two new aggregates of cytogenetically abnormal AML, the unfavorable risk MK-negative category (4-year OS, 26% +/- 2%) and the highly unfavorable risk MK-positive category (4-year OS, 4% +/- 1%).
Keywords
Adolescent, Adult, Humans, Karyotyping/methods, Leukemia, Myeloid, Acute/genetics, Middle Aged, Prognosis, Survival Analysis
Pubmed
Web of science
Create date
30/09/2009 13:56
Last modification date
20/08/2019 15:03
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