Complex and monosomal karyotype are distinct cytogenetic entities with an adverse prognostic impact in paediatric acute myeloid leukaemia. A NOPHO-DBH-AML study.
Ninna BagerKristian L Juul-DamJulie D SandahlJonas AbrahamssonBerna BeverlooEveline S J M de BontShau-Yin HaKirsi JahnukainenÓlafur G JónssonGertjan L KaspersZhanna KovalovaBirgitte LausenBarbara De MoerlooseUlrika Noren-NyströmJosefine PalleKadri SaksBernward ZellerEigil KjeldsenHenrik HaslePublished in: British journal of haematology (2018)
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.
Keyphrases
- end stage renal disease
- chronic kidney disease
- ejection fraction
- newly diagnosed
- acute myeloid leukemia
- stem cell transplantation
- peritoneal dialysis
- immune response
- prognostic factors
- intensive care unit
- risk assessment
- protein kinase
- palliative care
- emergency department
- dna methylation
- patient reported outcomes
- hepatitis b virus
- young adults
- allogeneic hematopoietic stem cell transplantation
- acute lymphoblastic leukemia
- big data
- drug induced
- childhood cancer
- middle aged