TY - JOUR
T1 - Monosomal karyotype in adult acute myeloid leukemia
T2 - Prognostic impact and outcome after different treatment strategies
AU - Kayser, Sabine
AU - Zucknick, Manuela
AU - Döhner, Konstanze
AU - Krauter, Jürgen
AU - Köhne, Claus Henning
AU - Horst, Heinz A.
AU - Held, Gerhard
AU - Von Lilienfeld-Toal, Marie
AU - Wilhelm, Sibylla
AU - Rummel, Mathias
AU - Germing, Ulrich
AU - Götze, Katharina
AU - Nachbaur, David
AU - Schlegelberger, Brigitte
AU - Göhring, Gudrun
AU - Späth, Daniela
AU - Morlok, Carina
AU - Teleanu, Veronica
AU - Ganser, Arnold
AU - Döhner, Hartmut
AU - Schlenk, Richard F.
PY - 2012/1/12
Y1 - 2012/1/12
N2 - We aimed to determine the prognostic impact of monosomal karyotype (MK) in acute myeloid leukemia (AML) in the context of the currentWorld 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.
AB - We aimed to determine the prognostic impact of monosomal karyotype (MK) in acute myeloid leukemia (AML) in the context of the currentWorld 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.
UR - http://www.scopus.com/inward/record.url?scp=84855857727&partnerID=8YFLogxK
U2 - 10.1182/blood-2011-07-367508
DO - 10.1182/blood-2011-07-367508
M3 - Article
C2 - 22096250
AN - SCOPUS:84855857727
SN - 0006-4971
VL - 119
SP - 551
EP - 558
JO - Blood
JF - Blood
IS - 2
ER -