Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Hematology, COMPLEX ABERRANT KARYOTYPE, ACUTE MYELOGENOUS LEUKEMIA, 1ST COMPLETE REMISSION, MYELODYSPLASTIC SYNDROME, WORKING PARTY, POSTREMISSION THERAPY, PROGNOSTIC VALUE, EUROPEAN GROUP, AML, RELAPSE, Adolescent, Adult, Aged, Allografts, Chromosome Deletion, Chromosomes, Human, Pair 7, Disease-Free Survival, Female, Follow-Up Studies, Histocompatibility Testing, Humans, Leukemia, Myeloid, Acute, Male, Middle Aged, Registries, Retrospective Studies, Stem Cell Transplantation, Survival Rate, 1102 Cardiorespiratory Medicine and Haematology, Immunology, 3201 Cardiovascular medicine and haematology

Abstract:

Monosomy 7 or deletion 7q (-7/7q-) is the most frequent adverse cytogenetic features reported in acute myeloid leukemia (AML), and is a common indication for allogeneic stem cell transplantation (SCT). Nevertheless, -7/7q- occurs frequently with other high-risk cytogenetic abnormalities such as complex karyotype (CK), monosomal karyotype (MK), monosomy 5 or deletion 5q (-5/5q-), 17p abnormalities (abn(17p)) or inversion of chromosome 3 (inv(3)), the presence of which may influence the outcomes after SCT. A total of 1109 patients were allocated to this study. Two-year probability of leukemia-free survival (LFS) and overall survival (OS) were 30% and 36%, respectively. Two-year probability of non-relapse mortality (NRM) was 20%. We defined five different cytogenetic subgroups: the "-7/7q- ± CK group- designated group1," the "MK group-designated group 2," the "-5/5q- group- designated group 3," the "abn(17p) group- designated group 4" and the "inv(3) group- designated group 5." The 2-year probability of LFS in first remission was 48% for group 1, 36.4% for group 2, 28.4% for group 3, 19.1% for group 4 and 17.3% for group 5, respectively (P < .001). Multivariate analysis confirmed those significant differences across groups. Note, SCT in -7/7q- AML provides durable responses in one third of the patients. The presence of -7/7q- with or without CK in the absence of MK, abn(17p) or inv(3) is associated with a better survival after SCT. On the contrary, addition of MK, -5/5q-, abn(17p) or inv(3) identifies a sub-group of patients with poor prognosis even after SCT.