Dismal prognostic value of monosomal karyotype in elderly patients with acute myeloid leukemia: a GOELAMS study of 186 patients with unfavorable cytogenetic abnormalities

作者：Perrot Aurore^*; Luquet Isabelle; Pigneux Arnaud; Mugneret Francine; Delaunay Jacques; Harousseau Jean Luc; Barin Carole; Cahn Jean Yves; Guardiola Philippe; Himberlin Chantal; Recher Christian; Vey Norbert; Lioure Bruno; Ojeda Uribe Mario; Fegueux Nathalie; Berthou Christian; Randriamalala Edouard; Bene Marie C; Ifrah Norbert; Witz Francis

来源：Blood, 2011, 118(3): 679-685.

DOI：10.1182/blood-2010-09-307264

The prognosis of acute myeloid leukemia (AML) is very poor in elderly patients, especially in those classically defined as having unfavorable cytogenetics. The recent monosomal karyotype (MK) entity, defined as 2 or more autosomal monosomies or combination of 1 monosomy with structural abnormalities, has been reported to be associated with a worse outcome than the traditional complex karyotype (CK). In this retrospective study of 186 AML patients older than 60 years, the prognostic influence of MK was used to further stratify elderly patients with unfavorable cytogenetics. CK was observed in 129 patients (69%), and 110 exhibited abnormalities according to the definition of MK (59%). MK(+) patients had a complete response rate significantly lower than MK(-) patients: 37% vs 64% (P = .0008), and their 2-year overall survival was also decreased at 7% vs 22% (P < .0001). In multivariate analysis, MK appeared as the major independent prognostic factor related to complete remission achievement (odds ratio = 2.3; 95% confidence interval, 1-5.4, P = .05) and survival (hazard ratio = 1.7; 95% confidence interval, 1.1-2.5, P = .008). In the subgroup of 129 CK(+) patients, survival was dramatically decreased for MK(+) patients (8% vs 28% at P = .03). These results demonstrate that MK is a major independent factor of very poor prognosis in elderly AML. (Blood. 2011;118(3):679-685)

• 出版日期2011-7-21
• 单位河南工业大学