title: Outcome of high-risk acute myeloid leukemia after allogeneic hematopoietic cell transplantation: negative impact of abnl(17p) and -5/5q-.
abstract: The European LeukemiaNet classification combines a heterogeneous group of aberrations as adverse-risk abnormalities. Our goal was to investigate the outcomes associated with distinct high-risk chromosomal abnormalities in acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). We performed a retrospective cohort analysis in patients with high-risk AML who received first, HLA-compatible, allogeneic HSCT between January 2005 and December 2008. Data from 236 patients with a median age of 55 years were included. Because complex karyotype (CK), -5/5q-, and abnl(17p) are overlapping categories, a hierarchical classification system based on the presence or absence of abnl(17p) and -5/5q- was developed. Patients with abnl(17p) had a 2-year event-free survival (EFS) of 11% (95% confidence interval [CI], 0%-25%), patients with -5/5q- but no abnl(17p) a 2-year EFS of 29% (95% CI, 14%-44%), and patients with adverse-risk AML but neither of the 2 marker lesions a 2-year EFS of 49% (95% CI, 39%-59%). Notably, complex and monosomal karyotypes lost their prognostic value when these marker lesions were excluded. In conclusion, hierarchical classification of adverse-risk karyotypes by 2 marker lesions, abnl(17p) and -5/5q-, is effective in prognostication of the outcome of allogeneic HSCT in AML.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Germany.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Middeke
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beelen
authors.forename: Michael
authors.initials: M
authors.lastname: Stadler
authors.forename: Gudrun
authors.initials: G
authors.lastname: Göhring
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schlegelberger
authors.forename: Herrad
authors.initials: H
authors.lastname: Baurmann
authors.forename: Gesine
authors.initials: G
authors.lastname: Bug
authors.forename: Frauke
authors.initials: F
authors.lastname: Bellos
authors.forename: Brigitte
authors.initials: B
authors.lastname: Mohr
authors.forename: Stefanie
authors.initials: S
authors.lastname: Buchholz
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Ute
authors.initials: U
authors.lastname: Hegenbart
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: Johannes
authors.initials: J
authors.lastname: Schetelig
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics*; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics*; D005260:Female; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D006680:HLA Antigens