The impact of abn(17p) and monosomy -5/del(5q) on the prognostic value of the monosomal karyotype in acute myeloid leukemia.

摘要

Acute myeloid leukemia (AML) with monosomal karyotype (MK) at diagnosis has been established as a subset of AML patients with very poor prognosis. After the initial publication by the Dutch-Belgian Hemato-Oncology Cooperative Group and Swiss Group for Clinical Cancer Research (HOVON/SAKK),1 several studies confirmed the very unfavorable prognostic significance of AML-MK.2'3 Recently, Middeke et al4 reported that MK and complex karyotypes in AML lost their excessively poor prognostic value after allogeneic stem cell transplantation (SCT) when AML with abn(17p) or — 5/del(5q) were excluded from the AML-MK or AML-complex karyotypes subcategories. Although the impact of abn(17p) or — 5/del(5q) among MK was also studied in our original publication,1 the prognostic distinction that was proposed by Middeke et al was not apparent in our analysis. We set out to examine whether we could confirm the observations of Middeke et al in an expanded cohort of 2898 newly diagnosed AML patients 15 to 60 years of age entered into 5 successive HOVON/SAKK trials between 1987 and 2008.5"9