Independent Prognostic Significance of Monosomy 17 and Impact of Karyotype Complexity in Monosomal Karyotype/Complex Karyotype Acute Myeloid Leukemia: Results from Four ECOG-ACRIN Prospective Therapeutic Trials.

Autor: Strickland SA; Vanderbilt-Ingram Cancer Center, Nashville, TN, United States. Electronic address: stephen.strickland@vanderbilt.edu., Sun Z; Frontier Science and Technology Research Foundation and Harvard School of Public Health, Boston, MA, United States., Ketterling RP; Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, United States., Cherry AM; Stanford University School of Medicine, Stanford, CA, United States., Cripe LD; Indiana University Cancer Center, Indianapolis, IN, United States., Dewald G; Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, United States., Fernandez HF; Moffitt Cancer Center and Research Institute, Tampa, FL, United States., Hicks GA; Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, United States., Higgins RR; Cytogenetics Laboratory, Allina Health-Abbott Northwestern Hospital, Minneapolis, MN, United States., Lazarus HM; University Hospitals Cleveland Medical Center, Cleveland, OH, United States., Litzow MR; Division of Hematology, Mayo Clinic, Rochester, MN, United States., Luger SM; Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States., Paietta EM; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States., Rowe JM; Shaare Zedek Medical Center, Jerusalem, Israel., Vance GH; Indiana University School of Medicine, Indianapolis, IN, United States., Wiernik P; Cancer Research Foundation of New York, United States., Wiktor AE; Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, United States., Zhang Y; Department of Pathology, Memorial Sloan Kettering Cancer Center, United States., Tallman MS; Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States.
Jazyk: angličtina
Zdroj: Leukemia research [Leuk Res] 2017 Aug; Vol. 59, pp. 55-64. Date of Electronic Publication: 2017 May 12.
DOI: 10.1016/j.leukres.2017.05.010
Abstrakt: The presence of a monosomal karyotype (MK+) and/or a complex karyotype (CK+) identifies subcategories of AML with poor prognosis. The prognostic significance of the most common monosomies (monosomy 5, monosomy 7, and monosomy 17) within MK+/CK+AML is not well defined. We analyzed data from 1,592 AML patients age 17-93 years enrolled on ECOG-ACRIN therapeutic trials. The majority of MK+ patients (182/195; 93%) were MK+/CK+ with 87% (158/182) having ≥5 clonal abnormalities (CK≥5). MK+ patients with karyotype complexity ≤4 had a median overall survival (OS) of 0.4y compared to 1.0y for MK- with complexity ≤4 (p<0.001), whereas no OS difference was seen in MK+vs. MK- patients with CK≥5 (p=0.82). Monosomy 5 (93%; 50/54) typically occurred within a highly complex karyotype and had no impact on OS (0.4y; p=0.95). Monosomy 7 demonstrated no impact on OS in patients with CK≥5 (p=0.39) or CK≤4 (p=0.44). Monosomy 17 appeared in 43% (68/158) of CK≥5 patients and demonstrated statistically significant worse OS (0.4y) compared to CK≥5 patients without monosomy 17 (0.5y; p=0.012). Our data suggest that the prognostic impact of MK+is limited to those with less complex karyotypes and that monosomy 17 may independently predict for worse survival in patients with AML.
(Copyright © 2017 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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