Prognostic impact of monosomal karyotype in young adult and elderly acute myeloid leukemia: the Southwest Oncology Group (SWOG) experience
Prognostic impact of monosomal karyotype in young adult and elderly acute myeloid leukemia: the Southwest Oncology Group (SWOG) experience
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DOI：
10.1182/blood-2010-02-270330
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发表时间：
2010-09-30
期刊：
影响因子：
20.3
通讯作者：
Appelbaum, Frederick R.
中科院分区：
文献类型：
--
作者：
Medeiros, Bruno C.;Othus, Megan;Appelbaum, Frederick R.
单染色体核型（MK），定义为2个或更多的单体，或存在结构异常的单个单体，最近被报道为鉴别预后极差的急性髓性白血病（AML）患者的一个独特亚群。为了证实这一观察结果，我们分析了1344名年龄在16岁至88岁之间接受西南肿瘤小组治疗的AML患者的MK对预后的影响。176例（13%）患者出现MK。MK患者的比例随着年龄的增长而增加，在30岁或以下的患者中有4%存在，但在60岁以上的患者中有20%存在。98%的MK病例属于不利的细胞遗传风险类别，占该组的40%。无MK的不良细胞遗传学患者的完全缓解率为34%，MK患者为18% （P < 0.01）。细胞遗传学不良但无MK患者的4年总生存率为13%，而MK患者的4年生存率仅为3% （P < 0.01）。因此，MK定义了相当大一部分细胞遗传学不良的患者预后特别差。(血。2010;116 (13):2224 - 2228)
Monosomal karyotype (MK), defined as 2 or more monosomies, or a single monosomy in the presence of structural abnormalities, has recently been reported as identifying a distinct subset of acute myeloid leukemia (AML) patients with an extremely poor prognosis. In an effort to confirm this observation, we analyzed the prognostic impact of MK in 1344 AML patients between the ages of 16 and 88 years treated on Southwest Oncology Group protocols. MK was found in 176 (13%) patients. The proportion of patients with MK increased with age, being present in 4% of patients age 30 or younger, but in 20% of those over age 60. Ninety-eight percent of MK cases were within the unfavorable cytogenetic risk category and comprised 40% of this group. The complete remission rate in patients with unfavorable cytogenetics without MK was 34% versus 18% with MK (P < .01). The 4-year overall survival of patients with unfavorable cytogenetics but without MK was 13% in contrast to a 4-year survival of only 3% with MK (P < .01). Thus, MK defines a sizeable subset of patients with unfavorable cytogenetics who have a particularly poor prognosis. (Blood. 2010;116(13):2224-2228)