Prognostic implications of chromosome 17 abnormalities in the context of monosomal karyotype in patients with acute myeloid leukemia and complex cytogenetics.
BACKGROUND
Chromosome 17 abnormalities are associated with poor outcome in leukemias including AML. Recently, MK was introduced as an independent predictor of dismal outcome in AML. The additional prognostic effect of C17 abns in patients with MK in a CK background is not clear.


METHODS
We conducted a retrospective analysis of 1086 patients with newly diagnosed AML treated between January 1998 and December 2007. Patients received treatment with one of the institution's first-line protocols.


RESULTS
Four hundred eighty-three patients had CK. Among them, 370 patients (77%) had CK-MK, and 195 patients (53%) had CK-MK-C17 abns. Patients with CK-MK had significantly shorter OS rates compared with patients with CK without MK (4.4 vs. 8 months, respectively; P = .002). The median OS for patients with CK-C17 abns was shorter than for patients without C17 abns (4 vs. 6.1 months, respectively; P = .004). In a multivariate analysis, the presence of MK among patients with CK was identified as an independent prognostic marker for OS. In addition, presence of C17 abns had a significant negative effect on OS among patients with CK-MK (P = .04).


CONCLUSIONS
Among patients with CK-AML, MK was associated with poor outcomes. Additional presence of C17 abns further worsens the outcome in these particularly poor-risk patients with AML.
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Aziz
A
Nazha
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Hagop M
HM
Kantarjian
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Vijaya R
VR
Bhatt
Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Graciela
G
Nogueras-Gonzalez
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Jorge E
JE
Cortes
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Tapan
T
Kadia
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Guillermo
G
Garcia-Manero
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Lynne
L
Abruzzo
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Naval
N
Daver
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Naveen
N
Pemmaraju
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Alfonso
A
Quintas-Cardama
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Farhad
F
Ravandi
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Michael
M
Keating
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX. Electronic address: gborthk@mdanderson.org.
Gautam
G
Borthakur
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics*; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D053208:Kaplan-Meier Estimate; D059785:Karyotype; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009006:Monosomy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014314:Trisomy; D055815:Young Adult
AML; Chromosome 17 abnormalities; Complex karyotype; Monosomal karyotype