Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb;22(2):248-257.
doi: 10.1016/j.bbmt.2015.08.024. Epub 2015 Aug 29.

Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

Marcelo C Pasquini  1 , Mei-Jie Zhang  2 , Bruno C Medeiros  3 , Philippe Armand  4 , Zhen-Huan Hu  5 , Taiga Nishihori  6 , Mahmoud D Aljurf  7 , Görgün Akpek  8 , Jean-Yves Cahn  9 , Mitchell S Cairo  10 , Jan Cerny  11 , Edward A Copelan  12 , Abhinav Deol  13 , César O Freytes  14 , Robert Peter Gale  15 , Siddhartha Ganguly  16 , Biju George  17 , Vikas Gupta  18 , Gregory A Hale  19 , Rammurti T Kamble  20 , Thomas R Klumpp  21 , Hillard M Lazarus  22 , Selina M Luger  23 , Jane L Liesveld  24 , Mark R Litzow  25 , David I Marks  26 , Rodrigo Martino  27 , Maxim Norkin  28 , Richard F Olsson  29 , Betul Oran  30 , Attaphol Pawarode  31 , Michael A Pulsipher  32 , Muthalagu Ramanathan  11 , Ran Reshef  23 , Ayman A Saad  33 , Wael Saber  5 , Bipin N Savani  34 , Harry C Schouten  35 , Olle Ringdén  36 , Martin S Tallman  37 , Geoffrey L Uy  38 , William A Wood Jr  39 , Baldeep Wirk  40 , Waleska S Pérez  5 , Minoo Batiwalla  41 , Daniel J Weisdorf  42
Affiliations

Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

Marcelo C Pasquini et al. Biol Blood Marrow Transplant. 2016 Feb.

Abstract

The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+ AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.

Keywords: Acute myeloid leukemia; Allogeneic transplantation; Monosomal karyotype; Myelodysplastic syndrome.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure Statement: There are no relevant conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Cumulative incidence of disease relapse for AML in first complete remission(1A) and MDS (1B) and overall survival for AML in first complete remission (1C) and MDS (1D) after HCT,
Figure 1
Figure 1
Cumulative incidence of disease relapse for AML in first complete remission(1A) and MDS (1B) and overall survival for AML in first complete remission (1C) and MDS (1D) after HCT,
Figure 2
Figure 2
Overall survival for AML in first complete remission (2A) and MDS (2B) after HCT defined as chromosome 7 abnormalities with or without monosomal karyotype (MK+) and normal karyotype
See this image and copyright information in PMC

Comment in

References

    1. Grimwade D, Walker H, Oliver F, et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children’s Leukaemia Working Parties. Blood. 1998;92:2322–2333. - PubMed
    1. Slovak ML, Kopecky KJ, Cassileth PA, et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood. 2000;96:4075–4083. - PubMed
    1. Breems DA, Van Putten WLJ, De Greef GE, et al. Monosomal Karyotype in Acute Myeloid Leukemia: A Better Indicator of Poor Prognosis Than a Complex Karyotype. J Clin Oncol. 2008;26:4791–4797. - PubMed
    1. Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89:2079–2088. - PubMed
    1. Schanz J, Tuchler H, Sole F, et al. New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge. J Clin Oncol. 2012;30:820–829. - PMC - PubMed