Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype

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Abstract

Monosomal karyotype (MK) defined by either ≥2 autosomal monosomies or single monosomy with at least one additional structural chromosomal abnormality is associated with a dismal prognosis in patients with acute myeloid leukemia (AML). It was detected in 174 of 3041 AML patients in South Korean Registry. A total of 119 patients who had received induction therapy were finally analyzed to evaluate the predictive factors for a positive prognosis. On multivariate analysis, single monosomy, the absence of abn(17p), ≥ 10% of cells with normal metaphase and the achievement of a complete remission (CR) after induction therapy were significant factors for more favorable outcomes. Especially, single monosomy remained as a significantly independent prognostic factor for superior survival in both patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR and who did not. Allo-HSCT in CR improved overall survival significantly only in patients with a single monosomy. Our results suggest that MK-AML may be biologically different according to the karyotypic subtype and that allo-HSCT in CR should be strongly recommended to patients with a single monosomy. For other patients, more prudent treatment strategies should be examined. Furthermore, the biological mechanism by which a single monosomy influences survival should be investigated.

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Jang, J. E., Min, Y. H., Yoon, J., Kim, I., Lee, J. H., Jung, C. W., … Cheong, J. W. (2015). Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype. Blood Cancer Journal, 5(10). https://doi.org/10.1038/bcj.2015.84

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