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%).
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 AMLpatients 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 AMLpatients 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%).
Authors: Vikas Gupta; Martin S Tallman; Wensheng He; Brent R Logan; Edward Copelan; Robert Peter Gale; Hanna J Khoury; Thomas Klumpp; John Koreth; Hillard M Lazarus; David I Marks; Rodrigo Martino; David A Rizzieri; Jacob M Rowe; Mitchell Sabloff; Edmund K Waller; John F DiPersio; Donald W Bunjes; Daniel J Weisdorf Journal: Blood Date: 2010-06-10 Impact factor: 22.113
Authors: H Nahi; M Remberger; M Machaczka; J Ungerstedt; J Mattson; O Ringden; Katarina Le-Blanc; P Ljungman; H Hägglund Journal: Med Oncol Date: 2012-01-11 Impact factor: 3.064
Authors: Bob Löwenberg; Thomas Pabst; Johan Maertens; Patrycja Gradowska; Bart J Biemond; Olivier Spertini; Edo Vellenga; Laimonas Griskevicius; Lidwine W Tick; Mojca Jongen-Lavrencic; Marinus van Marwijk Kooy; Marie-Christiane Vekemans; Walter J F M van der Velden; Berna Beverloo; Lucienne Michaux; Carlos Graux; Dries Deeren; Okke de Weerdt; Joost W J van Esser; Mario Bargetzi; Saskia K Klein; Alain Gadisseur; Peter E Westerweel; Hendrik Veelken; Michael Gregor; Tobias Silzle; Daniëlle van Lammeren-Venema; Ine Moors; Dimitri A Breems; Mels Hoogendoorn; Marie-Cecile J C Legdeur; Thomas Fischer; Juergen Kuball; Jan Cornelissen; Kimmo Porkka; Gunnar Juliusson; Peter Meyer; Martin Höglund; Bjorn T Gjertsen; Jeroen J W M Janssen; Gerwin Huls; Jakob Passweg; Jacqueline Cloos; Peter J M Valk; Catharina H M J van Elssen; Markus G Manz; Yngvar Floisand; Gert J Ossenkoppele Journal: Blood Adv Date: 2021-02-23