TY - JOUR
T1 - Complex and monosomal karyotype are distinct cytogenetic entities with an adverse prognostic impact in paediatric acute myeloid leukaemia. A NOPHO-DBH-AML study
AU - Bager, Ninna
AU - Juul-Dam, Kristian L.
AU - Sandahl, Julie D.
AU - Abrahamsson, Jonas
AU - Beverloo, Berna
AU - de Bont, Eveline S. J. M.
AU - Ha, Shau-Yin
AU - Jahnukainen, Kirsi
AU - Jónsson, Ólafur G.
AU - Kaspers, Gertjan L.
AU - Kovalova, Zhanna
AU - Lausen, Birgitte
AU - de Moerloose, Barbara
AU - Noren-Nyström, Ulrika
AU - Palle, Josefine
AU - Saks, Kadri
AU - Zeller, Bernward
AU - Kjeldsen, Eigil
AU - Hasle, Henrik
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056203633&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30406946
U2 - https://doi.org/10.1111/bjh.15587
DO - https://doi.org/10.1111/bjh.15587
M3 - Article
C2 - 30406946
SN - 0007-1048
VL - 183
SP - 618
EP - 628
JO - British journal of haematology
JF - British journal of haematology
IS - 4
ER -