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. 2011 Mar;96(3):375-83.
doi: 10.3324/haematol.2010.030957. Epub 2010 Nov 25.

Cytogenetic risk stratification in chronic myelomonocytic leukemia

Esperanza Such  1 , José Cervera, Dolors Costa, Francesc Solé, Teresa Vallespí, Elisa Luño, Rosa Collado, María J Calasanz, Jesús M Hernández-Rivas, Juan C Cigudosa, Benet Nomdedeu, Mar Mallo, Felix Carbonell, Javier Bueno, María T Ardanaz, Fernando Ramos, Mar Tormo, Reyes Sancho-Tello, Consuelo del Cañizo, Valle Gómez, Victor Marco, Blanca Xicoy, Santiago Bonanad, Carmen Pedro, Teresa Bernal, Guillermo F Sanz
Affiliations

Cytogenetic risk stratification in chronic myelomonocytic leukemia

Esperanza Such et al. Haematologica. 2011 Mar.

Abstract

Background: The prognostic value of cytogenetic findings in chronic myelomonocytic leukemia is unclear. Our purpose was to evaluate the independent prognostic impact of cytogenetic abnormalities in a large series of patients with chronic myelomonocytic leukemia included in the database of the Spanish Registry of Myelodysplastic Syndromes.

Design and methods: We studied 414 patients with chronic myelomonocytic leukemia according to WHO criteria and with a successful conventional cytogenetic analysis at diagnosis. Different patient and disease characteristics were examined by univariate and multivariate methods to establish their relationship with overall survival and evolution to acute myeloid leukemia.

Results: Patients with abnormal karyotype (110 patients, 27%) had poorer overall survival (P=0.001) and higher risk of acute myeloid leukemia evolution (P=0.010). Based on outcome analysis, three cytogenetic risk categories were identified: low risk (normal karyotype or loss of Y chromosome as a single anomaly), high risk (presence of trisomy 8 or abnormalities of chromosome 7, or complex karyotype), and intermediate risk (all other abnormalities). Overall survival at five years for patients in the low, intermediate, and high risk cytogenetic categories was 35%, 26%, and 4%, respectively (P<0.001). Multivariate analysis confirmed that this new CMML-specific cytogenetic risk stratification was an independent prognostic variable for overall survival (P=0.001). Additionally, patients belonging to the high-risk cytogenetic category also had a higher risk of acute myeloid leukemia evolution on univariate (P=0.001) but not multivariate analysis.

Conclusions: Cytogenetic findings have a strong prognostic impact in patients with chronic myelomonocytic leukemia.

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Figures

Figure 1.
Figure 1.
Unadjusted probability of overall survival according to (A) the new CMML-specific and (B) the IPSS cytogenetic risk classifications.
Figure 2.
Figure 2.
Unadjusted risk of AML evolution according to (A) the new CMML-specific and (B) the IPSS cytogenetic risk classifications.
See this image and copyright information in PMC

References

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