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Clinical Trial
. 2017 Aug:59:55-64.
doi: 10.1016/j.leukres.2017.05.010. Epub 2017 May 12.

Independent Prognostic Significance of Monosomy 17 and Impact of Karyotype Complexity in Monosomal Karyotype/Complex Karyotype Acute Myeloid Leukemia: Results from Four ECOG-ACRIN Prospective Therapeutic Trials

Stephen A Strickland  1 , Zhuoxin Sun  2 , Rhett P Ketterling  3 , Athena M Cherry  4 , Larry D Cripe  5 , Gordon Dewald  3 , Hugo F Fernandez  6 , Gary A Hicks  3 , Rodney R Higgins  7 , Hillard M Lazarus  8 , Mark R Litzow  9 , Selina M Luger  10 , Elisabeth M Paietta  11 , Jacob M Rowe  12 , Gail H Vance  13 , Peter Wiernik  14 , Anne E Wiktor  3 , Yanming Zhang  15 , Martin S Tallman  16 ; ECOG-ACRIN Cancer Research Group
Affiliations
Clinical Trial

Independent Prognostic Significance of Monosomy 17 and Impact of Karyotype Complexity in Monosomal Karyotype/Complex Karyotype Acute Myeloid Leukemia: Results from Four ECOG-ACRIN Prospective Therapeutic Trials

Stephen A Strickland et al. Leuk Res. 2017 Aug.

Abstract

The presence of a monosomal karyotype (MK+) and/or a complex karyotype (CK+) identifies subcategories of AML with poor prognosis. The prognostic significance of the most common monosomies (monosomy 5, monosomy 7, and monosomy 17) within MK+/CK+AML is not well defined. We analyzed data from 1,592 AML patients age 17-93 years enrolled on ECOG-ACRIN therapeutic trials. The majority of MK+ patients (182/195; 93%) were MK+/CK+ with 87% (158/182) having ≥5 clonal abnormalities (CK≥5). MK+ patients with karyotype complexity ≤4 had a median overall survival (OS) of 0.4y compared to 1.0y for MK- with complexity ≤4 (p<0.001), whereas no OS difference was seen in MK+vs. MK- patients with CK≥5 (p=0.82). Monosomy 5 (93%; 50/54) typically occurred within a highly complex karyotype and had no impact on OS (0.4y; p=0.95). Monosomy 7 demonstrated no impact on OS in patients with CK≥5 (p=0.39) or CK≤4 (p=0.44). Monosomy 17 appeared in 43% (68/158) of CK≥5 patients and demonstrated statistically significant worse OS (0.4y) compared to CK≥5 patients without monosomy 17 (0.5y; p=0.012). Our data suggest that the prognostic impact of MK+is limited to those with less complex karyotypes and that monosomy 17 may independently predict for worse survival in patients with AML.

Keywords: Complex Karyotype; Cytogenetics; Monosomal Karyotype; Monosomy 17; Monosomy 5; Monosomy 7; Myeloid Leukemia; Prognosis.

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Conflict of interest statement

Conflict of Interest

The authors declare no conflicts of interest pertaining to the content of this manuscript.

Figures

Figure 1
Figure 1
Overall Survival according to Monosomal Karyotype status and Karyotype Complexity among Patients with Non-CBF Clonal Cytogenetic Abnormalities
Figure 1
Figure 1
Overall Survival according to Monosomal Karyotype status and Karyotype Complexity among Patients with Non-CBF Clonal Cytogenetic Abnormalities
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
Figure 2
Figure 2
Overall Survival of MK patients according to Monosomy 5, Monosomy 7, or Monosomy 17 status and Karyotype Complexity
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