title: Monosomal karyotype in primary myelofibrosis is detrimental to both overall and leukemia-free survival.
abstract: Survival in cytogenetically high-risk patients with acute myeloid leukemia or myelodysplastic syndromes is significantly worse in the presence of a monosomal karyotype (MK). The objective of the present study was to determine whether the same held true for primary myelofibrosis. Among 793 primary myelofibrosis patients seen at our institution, 62 displayed an unfavorable karyotype by way of complex karyotype (n = 41) or sole trisomy 8 (n = 21). Seventeen (41%) of the 41 patients with complex karyotype were classified as having an MK. Median survival was 6, 24, and 20 months in patients with MK, complex karyotype without monosomies, and sole trisomy 8, respectively (P < .0001). The corresponding 2-year leukemic transformation rates were 29.4%, 8.3%, and 0 (P < .0001); hazard ratios (95% confidence intervals) were 6.9 (1.3-37.3) and 14.8 (1.7-130.8). The prognostic relevance of MK was not accounted for by the Dynamic International Prognostic Scoring System. We conclude that MK in primary myelofibrosis is associated with extremely poor overall and leukemia-free survival.
authors: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Rakhee
authors: R
authors: Vaidya
authors: Domenica
authors: D
authors: Caramazza
authors: Kebede H
authors: KH
authors: Begna
authors: Naseema
authors: N
authors: Gangat
authors: Daniel L
authors: DL
authors: Van Dyke
authors: Curtis A
authors: CA
authors: Hanson
authors: Animesh
authors: A
authors: Pardanani
authors: Ayalew
authors: A
authors: Tefferi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009006:Monosomy; D055728:Primary Myelofibrosis / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate