title: Prognostic significance of complex karyotype and monosomal karyotype in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols.
abstract: BACKGROUND
  The karyotype is a predictor of outcomes in adults with acute lymphoblastic leukemia (ALL). The unfavorable prognostic significance of complex karyotype (CK) has been reported, whereas the prognostic relevance of monosomal karyotype (MK) has not been consistently evaluated. We aimed to assess the prognostic value of CK and MK in adults with ALL treated with risk-adapted protocols of the Spanish PETHEMA Group.
  
  
  METHODS
  The karyotypes of 881 adult ALL patients treated according to the protocols of the PETHEMA Group between 1993 and 2012 were centrally reviewed. CK and MK were assessed according to Moorman's criteria, and Breem's criteria, respectively. Specific analyses according to the risk groups and to the presence of t(9:22) were performed.
  
  
  RESULTS
  Of 364 evaluable patients 33 (9.2%) had CK, and 68 of 535 evaluable patients (12.8%) had MK. Complete remission rate, remission duration, and overall survival were not significantly different according to the presence of CK or MK in the whole series, according to the B or T lineage, in the high-risk group, or in patients with t(9;22), regardless of imatinib treatment, and in patients who received chemotherapy alone or chemotherapy followed by stem cell transplantation
  
  
  CONCLUSIONS
  Our study shows that CK and MK were not associated with a worse prognosis in adult patients with ALL treated with risk-adapted or subtype-oriented protocols. In patients with Ph+ ALL, MK did not have an impact on prognosis irrespective of imatinib treatment.
authors.affiliation: Department of Hematology, ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute, Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Motlló
authors.forename: Josep-María
authors.initials: JM
authors.lastname: Ribera
authors.forename: Mireia
authors.initials: M
authors.lastname: Morgades
authors.forename: Isabel
authors.initials: I
authors.lastname: Granada
authors.forename: Pau
authors.initials: P
authors.lastname: Montesinos
authors.forename: José
authors.initials: J
authors.lastname: González-Campos
authors.forename: Pascual
authors.initials: P
authors.lastname: Fernández-Abellán
authors.forename: Mar
authors.initials: M
authors.lastname: Tormo
authors.forename: Concepción
authors.initials: C
authors.lastname: Bethencourt
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.forename: Jesús-María
authors.initials: JM
authors.lastname: Hernández-Rivas
authors.forename: María-José
authors.initials: MJ
authors.lastname: Moreno
authors.forename: Josep
authors.initials: J
authors.lastname: Sarrà
authors.forename: Eloy
authors.initials: E
authors.lastname: Del Potro
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.forename: Teresa
authors.initials: T
authors.lastname: Bernal
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Javier
authors.initials: J
authors.lastname: Grau
authors.forename: José
authors.initials: J
authors.lastname: Cervera
authors.forename: Evarist
authors.initials: E
authors.lastname: Feliu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D024221:Antineoplastic Protocols; D001549:Benzamides / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D059785:Karyotype; D007621:Karyotyping / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009006:Monosomy / Q000235:genetics*; D010879:Piperazines / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics*; D011237:Predictive Value of Tests; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D020379:Risk Adjustment; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate
keywords: acute lymphoblastic leukemia; adults; complex karyotype; monosomal karyotype; prognosis