title: Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype.
abstract: Monosomal karyotype (MK) defined by either ⩾2 autosomal monosomies or single monosomy with at least one additional structural chromosomal abnormality is associated with a dismal prognosis in patients with acute myeloid leukemia (AML). It was detected in 174 of 3041 AML patients in South Korean Registry. A total of 119 patients who had received induction therapy were finally analyzed to evaluate the predictive factors for a positive prognosis. On multivariate analysis, single monosomy, the absence of abn(17p), ⩾10% of cells with normal metaphase and the achievement of a complete remission (CR) after induction therapy were significant factors for more favorable outcomes. Especially, single monosomy remained as a significantly independent prognostic factor for superior survival in both patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR and who did not. Allo-HSCT in CR improved overall survival significantly only in patients with a single monosomy. Our results suggest that MK-AML may be biologically different according to the karyotypic subtype and that allo-HSCT in CR should be strongly recommended to patients with a single monosomy. For other patients, more prudent treatment strategies should be examined. Furthermore, the biological mechanism by which a single monosomy influences survival should be investigated.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: J E
authors.initials: JE
authors.lastname: Jang
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Min
authors.affiliation: Department of Hematology, Cancer Research Institute, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: J
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Division of Hematology-Medical Oncology, Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: I
authors.initials: I
authors.lastname: Kim
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: C W
authors.initials: CW
authors.lastname: Jung
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Department of Hemato-Oncology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Division of Hematology & Oncology, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
authors.forename: D-S
authors.initials: DS
authors.lastname: Hong
authors.affiliation: Department of Hematology and Oncology, Chonnam National University Hwasun Hospital, Hwasun, South Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Hematology, Cancer Research Institute, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Division of Hematology-Medical Oncology, Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: K-H
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Jang
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Chung
authors.affiliation: Department of Hemato-Oncology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea.
authors.forename: S M
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea.
authors.forename: J
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Division of Hematology & Oncology, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Hematology and Oncology, Chonnam National University Hwasun Hospital, Hwasun, South Korea.
authors.forename: J-S
authors.initials: JS
authors.lastname: Ahn
authors.affiliation: Department of Hematology, Cancer Research Institute, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: W-S
authors.initials: WS
authors.lastname: Min
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: J-W
authors.initials: JW
authors.lastname: Cheong
mesh_terms: D059786:Abnormal Karyotype; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044466:Asian People; D003131:Combined Modality Therapy; D020732:Cytogenetic Analysis; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009006:Monosomy / Q000235:genetics* / Q000473:pathology*; D016016:Proportional Hazards Models; D012042:Registries; D055815:Young Adult