PURPOSE: Karyotype is an independent indicator of prognosis in acute myeloid leukemia (AML) that is widely applied to risk-adapted therapy. Because AML is rare in children, the true prognostic significance of individual chromosomal abnormalities in this age group remains unclear. PATIENTS AND METHODS: This cytogenetic study of 729 childhood patients classified them into 22 subgroups and evaluated their incidence and risk. RESULTS: Rearrangements of 11q23 were the most frequent abnormality found in approximately 16% of patients, with 50% of these in infants. The outcome for all patients with 11q23 abnormalities was intermediate; no difference was observed for those with t(9;11)(p21-22;q23). The core binding factor leukemias with the translocations t(8;21)(q22;q22) and inv(16)(p13q22) occurred at incidences of 14% and 7%, respectively, predominantly in older children, and their prognosis was favorable. An adverse outcome was observed in patients with monosomy 7, abnormalities of 5q, and t(6;9)(p23;q34). Abnormalities of 3q and complex karyotypes, in the absence of favorable-risk features, have been associated with an adverse outcome in adults, but the results were not significant in this childhood series. However, the presence of 12p abnormalities predicted a poor outcome. CONCLUSION: Because the spectrum of chromosomal changes and their risk association seem to differ between children and adults with AML, biologic differences are emerging, which will contribute to the redefinition of risk stratification for different age groups in the future.
PURPOSE: Karyotype is an independent indicator of prognosis in acute myeloid leukemia (AML) that is widely applied to risk-adapted therapy. Because AML is rare in children, the true prognostic significance of individual chromosomal abnormalities in this age group remains unclear. PATIENTS AND METHODS: This cytogenetic study of 729 childhood patients classified them into 22 subgroups and evaluated their incidence and risk. RESULTS: Rearrangements of 11q23 were the most frequent abnormality found in approximately 16% of patients, with 50% of these in infants. The outcome for all patients with 11q23 abnormalities was intermediate; no difference was observed for those with t(9;11)(p21-22;q23). The core binding factor leukemias with the translocations t(8;21)(q22;q22) and inv(16)(p13q22) occurred at incidences of 14% and 7%, respectively, predominantly in older children, and their prognosis was favorable. An adverse outcome was observed in patients with monosomy 7, abnormalities of 5q, and t(6;9)(p23;q34). Abnormalities of 3q and complex karyotypes, in the absence of favorable-risk features, have been associated with an adverse outcome in adults, but the results were not significant in this childhood series. However, the presence of 12p abnormalities predicted a poor outcome. CONCLUSION: Because the spectrum of chromosomal changes and their risk association seem to differ between children and adults with AML, biologic differences are emerging, which will contribute to the redefinition of risk stratification for different age groups in the future.
Authors: G Michel; R Cunha; A Ruggeri; T A O'Brien; H Bittencourt; J H Dalle; F Locatelli; A P Iori; M Mauad; C Oudin; F Giannotti; F Volt; E Gluckman; P Bader; V Rocha Journal: Leukemia Date: 2015-09-15 Impact factor: 11.528
Authors: Jasmijn D E de Rooij; Marry M van den Heuvel-Eibrink; Malou C H Hermkens; Lonneke J Verboon; Susan T C J M Arentsen-Peters; Maarten Fornerod; Andre Baruchel; Jan Stary; Dirk Reinhardt; Valerie de Haas; Rob Pieters; C Michel Zwaan Journal: Haematologica Date: 2015-01-16 Impact factor: 9.941
Authors: A-L Alloin; G Leverger; J-H Dalle; C Galambrun; Y Bertrand; A Baruchel; A Auvrignon; V Gandemer; C Ragu; A Loundou; C Bilhou-Nabera; M Lafage-Pochitaloff; N Dastugue; B Nelken; C Jubert; F Rialland; G Plat; C Pochon; J-P Vannier; P-S Rohrlich; J Kanold; P Lutz; A Sirvent; C Oudin; W Cuccuini; G Michel Journal: Bone Marrow Transplant Date: 2016-12-12 Impact factor: 5.483
Authors: Chi Keung Cheng; Tsz Ki Kwan; Chi Ying Cheung; Kitty Ng; Pei Liang; Suk Hang Cheng; Natalie P H Chan; Rosalina K L Ip; Raymond S M Wong; Vincent Lee; Chi Kong Li; Sze Fai Yip; Margaret H L Ng Journal: Haematologica Date: 2012-10-12 Impact factor: 9.941