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

Sabine Kayser, Manuela Zucknick, Konstanze Döhner, Jürgen Krauter, Claus Henning Köhne, Heinz A. Horst, Gerhard Held, Marie Von Lilienfeld-Toal, Sibylla Wilhelm, Mathias Rummel, Ulrich Germing, Katharina Götze, David Nachbaur, Brigitte Schlegelberger, Gudrun Göhring, Daniela Späth, Carina Morlok, Veronica Teleanu, Arnold Ganser, Hartmut DöhnerRichard F. Schlenk

Research output: Contribution to journalArticlepeer-review

140 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)551-558
Number of pages8
JournalBlood
Volume119
Issue number2
DOIs
StatePublished - 12 Jan 2012
Externally publishedYes

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