Prognosis of acute myeloid leukemia harboring monosomal karyotype in patients treated with or without allogeneic hematopoietic cell transplantation after achieving complete remission

Yanada, Masamitsu; Kurosawa, Saiko; Yamaguchi, Takuhiro; Yamashita, Takuya; Moriuchi, Yukiyoshi; Ago, Hiroatsu; Jin, Tao; Nakamae, Hirohisa; Taguchi, Jun; Sakura, Toru; Takamatsu, Yasushi; Waki, Fusako; Yokoyama, Hiroyuki; Watanabe, Masato; Emi, Nobuhiko; Fukuda, Takahiro

doi:10.3324/haematol.2011.058289

Cited by 27 publications

(24 citation statements)

References 18 publications

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“…(2) Uneven geographic distribution of nonrandom chromosome aberrations in malignant disorders and ethic differences could be another possible explanation. Recently, Masamitsu Y et al reported MK was noted in 4% patients of Japanese AML patients who had achieved complete remission (Yanada et al, 2012). Given MK+ AML patients had a lower CR rate than MK-patients, the incidence of MK among newly diagnosed Japanese AML patients might be similar with that in our study.…”

Section: Discussionsupporting

confidence: 88%

“…We speculated that the dismal outcome of MK+CK+ patients in our study might be partly due to their lower CR rate than MK-CK+ group, although the difference was not statistically significant. In addition, inferior OS of MK+ AML patients can also be explained by a high risk of relapse of AML (Yanada et al, 2012). To further determine the implication of MK in response to induction therapy and RFS, a larger series of cases need to be studied.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Sun²,

Yin³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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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.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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

Yang

Sun²,

Yin³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Based on this result, we agree that SCT should be considered for all AML patients harbouring a MK. Comparing to other studies, we have only included here patients in CR1 which is significantly associated with a better outcome [9,10,23]. However, we have to assume a selection bias, because only patients who were fit enough to survive to the point of being eligible for allogeneic SCT have been included in this study.…”

Section: Discussionmentioning

confidence: 99%

“…This benefit should rely at least in part on a potential graft-versus-leukemia effect (GvL) in MK AML. 1 Nevertheless, if SCT can improve survival in the presence of a MK, this benefit remains limited with an estimated long-term survival after SCT of only 20 2 30% [9,10,12]. Therefore, efforts have to be made to improve outcome in MK AML after SCT either with pre-and/or posttransplantation strategies.…”

Section: Introductionmentioning

confidence: 99%

Outcome of conditioning intensity in acute myeloid leukemia with monosomal karyotype in patients over 45 year‐old: A study from the acute leukemia working party (ALWP) of the European group of blood and marrow transplantation (EBMT)

et al. 2015

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Acute myeloid leukemia with monosomal karyotype (MK AML) carries a very poor prognosis, even after allogeneic stem cell transplantation (SCT). However, SCT remains the only curative option in this high-risk population. Because myeloablative conditioning regimen (MAC) is associated with less relapse, we hypothesized that more intensive conditioning regimen might be beneficial for MK AML patients. We reviewed 303 patients over age 45 diagnosed with either de novo or secondary MK AML. One hundred and five patients received a MAC and 198 a reduced-intensity conditioning (RIC). The median age at SCT was 57-year-old, significantly lower in the MAC (53-year-old) than in the RIC group (59-year-old). The median followup was 42 months (range, 3 2 156 months). The 3-year overall survival (OS), leukemia-free survival (LFS), and relapse rate (RR) were not significantly different between both groups with overall values of 34%, 29%, and 51%, respectively. On the contrary, the 3-year nonrelapse mortality (NRM) was significantly higher in MAC recipients (28%) compared with RIC patients (16%, P 5 0.004). The incidence of Grades II to IV acute graftversus-host disease (GvHD) was significantly higher after a MAC (30.5%) than after a RIC (19.3%, P 5 0.02). That of chronic GvHD was comparable between both groups (35%) and did not impact on LFS. Interestingly, within our MK AML cohort, hypodiploidy was significantly associated with worse outcomes. Due to reduced toxicity and comparable OS, LFS, and RR, RIC appears as a good transplant option in the very high-risk population, including older patients, diagnosed with MK AML.

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“…An allogeneic HSCT is almost a prerequisite for prolonged survival in patients with unfavourable cytogenetic risk Stelljes et al, 2011). Younger patients with 11q23 aberrations also benefit from an allogeneic HSCT , while the beneficial effect in patients with monosomal karyotype is marginal Yanada et al, 2012). In donor versus no donor meta-analyses of younger patients with AML, patients with non-favourable cytogenetic risk and younger patients below the age of 35 years benefitted from a donor over no available donor (Cornelissen et al, 2007;Koreth et al, 2009).…”

Section: Postremission Therapy In Patients In Cr After Induction Therapymentioning

confidence: 99%

Prognostic factors for acute myeloid leukaemia in adults - biological significance and clinical use

et al. 2014

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Prognosis of acute myeloid leukemia harboring monosomal karyotype in patients treated with or without allogeneic hematopoietic cell transplantation after achieving complete remission

Abstract: ABSTRACTof MK, the present analysis focused on patients who achieved CR with one or two courses of chemotherapy.

Cited by 27 publications

References 18 publications

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

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

Outcome of conditioning intensity in acute myeloid leukemia with monosomal karyotype in patients over 45 year‐old: A study from the acute leukemia working party (ALWP) of the European group of blood and marrow transplantation (EBMT)

Prognostic factors for acute myeloid leukaemia in adults - biological significance and clinical use

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