Complex and monosomal karyotype are distinct cytogenetic entities with an adverse prognostic impact in paediatric acute myeloid leukaemia. A NOPHO-DBH-AML study
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2018-11
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Abstract
Data on occurrence, genetic characteristics and prognostic impact of complex and monosomal karyotype (CK/MK) in children with acute myeloid leukaemia (AML) are scarce. We studied CK and MK in a large unselected cohort of childhood AML patients diagnosed and treated according to Nordic Society for Paediatric Haematology and Oncology (NOPHO)-AML protocols 1993–2015. In total, 800 patients with de novo AML were included. CK was found in 122 (15%) and MK in 41 (5%) patients. CK and MK patients were young (median age 2·1 and 3·3 years, respectively) and frequently had FAB M7 morphology (24% and 22%, respectively). Refractory disease was more common in MK patients (15% vs. 4%) and stem cell transplantation in first complete remission was more frequent (32% vs. 19%) compared with non-CK/non-MK patients. CK showed no association with refractory disease but was an independent predictor of an inferior event-free survival (EFS; hazard ratio [HR] 1·43, P = 0·03) and overall survival (OS; HR 1·48, P = 0·01). MK was associated with a poor EFS (HR 1·57, P = 0·03) but did not show an inferior OS compared to non-MK patients (HR 1·14, P = 0·62). In a large paediatric cohort, we characterized AML with non-recurrent abnormal karyotype and unravelled the adverse impact of CK and MK on prognosis.
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Funding Information: The study was supported by the Danish Childhood Cancer Foundation. Furthermore, all the work done by the cytogenetic groups in NOPHO is acknowledged. Publisher Copyright: © 2018 British Society for Haematology and John Wiley & Sons Ltd
Keywords
Acute myeloid leukaemia, complex karyotype, monosomal karyotype, paediatrics, refractory disease, 3.2 Clinical medicine, 1.1. Scientific article indexed in Web of Science and/or Scopus database, Hematology
Citation
Bager, N, Juul-Dam, K L, Sandahl, J D, Abrahamsson, J, Beverloo, B, de Bont, E S J M, Ha, S Y, Jahnukainen, K, Jónsson, Ó G, Kaspers, G L, Kovalova, Z, Lausen, B, De Moerloose, B, Noren-Nyström, U, Palle, J, Saks, K, Zeller, B, Kjeldsen, E & Hasle, H 2018, 'Complex and monosomal karyotype are distinct cytogenetic entities with an adverse prognostic impact in paediatric acute myeloid leukaemia. A NOPHO-DBH-AML study', British Journal of Haematology, vol. 183, no. 4, pp. 618-628. https://doi.org/10.1111/bjh.15587