Monosomal Karyotypes among 1147 Chinese Patients with Acute Myeloid Leukemia: Prevalence, Features and Prognostic Impact

Abstract

A monosomal karyotype (MK), defined as ≥2 autosomal monosomies or a single monosomy in the presence of additional structural abnormalities, was recently identified as an independent prognostic factor conveying an extremely poor prognosis in patients with acute myeloid leukemia (AML). In the present study, after excluding patients with t(15;17), t(8;21), inv(16) and normal karyotypes, 324 AML patients with cytogenetic abnormalities were the main subject of analysis. The incidences of MK were 13% in patients aged 15 to 60 years and 18% in those between 15 and 88 years old. MK was much more prevalent among elderly patients (p < 0.001) and was significantly associated with the presence of -7, -5, del(5q), abn12p, abn17p, -18 or 18q-, -20 or 20q-and CK (for all p < 0.001 except for abn12p p=0.009), and +8 or +8q was less frequent in MK+ AML(p=0.007). No correlation was noted between monosomal karyotype and FAB subtype (p > 0.05); MK remained significantly associated with worse overall survival among patients with complex karyotype (p= 0.032); A single autosomal monosomy contributed an additional negative effect in OS of patients with structural cytogenetic abnormalities (P=0.008). This report presents the prevalence, feature and prognostic impact of MK among a large series of Chinese AML patients from a single center for the first time.

Mutations of myelodysplastic syndromes (MDS): An update

“…CK lost its prognostic significance when MK was taken into consideration for prognostic evaluation. In concordance to Breems et al [129], negative effect on OS of single monosomy has been demonstrated by Yang et al [132] in Chinese AML population.…”

Prognostic significance of complex karyotype and monosomal karyotype in adult patients with acute lymphoblastic leukemia treated with risk‐adapted protocols

“…The prevalence of MK in AML is 20%-30% in non-Asian patients 7,9,20 and less than 20% in Asian patients. 21 The most frequent monosomies observed in AML involve chromosomes 5 and 7, 20,21 but all autosomal chromosomes have reportedly been involved. 21 In the present study, the incidence of MK in adult ALL patients was 12.8%, lower than that found in AML.…”

“…21 The most frequent monosomies observed in AML involve chromosomes 5 and 7, 20,21 but all autosomal chromosomes have reportedly been involved. 21 In the present study, the incidence of MK in adult ALL patients was 12.8%, lower than that found in AML. Different from that in AML patients, the frequency of involvement of chromosomes 5 and 7 was low, and there was no predominance of any specific monosomy.…”

“…In that study MK was defined as any karyotype without core‐binding factor‐associated chromosomal abnormalities that presented 2 or more monosomies or 1 monosomy associated with a structural abnormality. The prevalence of MK in AML is 20%‐30% in non‐Asian patients and less than 20% in Asian patients . The most frequent monosomies observed in AML involve chromosomes 5 and 7, but all autosomal chromosomes have reportedly been involved .…”

Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

“…MK+ AML yields low rates (only 20 to 30%) of CR and short remission duration yielding reported median survival of 8 to 10 months with 2 year survival less than 10% (3, 13, 20, 31, 32). The current HCT study includes only those achieving CR after induction therapy.…”