title: Karyotype complexity and prognosis in acute myeloid leukemia.
abstract: A complex aberrant karyotype consisting of multiple unrelated cytogenetic abnormalities is associated with poor prognosis in patients with acute myeloid leukemia (AML). The European Leukemia Net classification and the UK Medical Research Council recommendation provide prognostic categories that differ in the definition of unbalanced aberrations as well as the number of single aberrations. The aim of this study on 3526 AML patients was to redefine and validate a cutoff for karyotype complexity in AML with regard to adverse prognosis. Our study demonstrated that (1) patients with a pure hyperdiploid karyotype have an adverse risk irrespective of the number of chromosomal gains, (2) patients with translocation t(9;11)(p21∼22;q23) have an intermediate risk independent of the number of additional aberrations, (3) patients with ⩾4 abnormalities have an adverse risk per se and (4) patients with three aberrations in the absence of abnormalities of strong influence (hyperdiploid karyotype, t(9;11)(p21∼22;q23), CBF-AML, unique adverse-risk aberrations) have borderline intermediate/adverse risk with a reduced overall survival compared with patients with a normal karyotype.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Stölzel
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Mohr
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Oelschlägel
authors.affiliation: Abteilung Innere Medizin V, Universität Heidelberg, Heidelberg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Bochtler
authors.affiliation: Medizinische Klinik A, Universitätsklinikum Münster, Münster, Germany.
authors.forename: W E
authors.initials: WE
authors.lastname: Berdel
authors.affiliation: Robert Bosch Hospital, Stuttgart, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kaufmann
authors.affiliation: Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: C D
authors.initials: CD
authors.lastname: Baldus
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Schäfer-Eckart
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Stuhlmann
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Einsele
authors.affiliation: Medizinische Klinik 5, Universitätsklinikum Erlangen, Erlangen, Germany.
authors.forename: S W
authors.initials: SW
authors.lastname: Krause
authors.affiliation: Medizinische Klinik II, Klinikum der J.W. Goethe Universität, Frankfurt, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Serve
authors.affiliation: Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hänel
authors.affiliation: Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Herbst
authors.affiliation: Kliniken für Innere Medizin, Hämatologie/Onkologie und Immunologie, Universitätsklinikum Marburg, Marburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Neubauer
authors.affiliation: Kliniken für Innere Medizin, Hämatologie/Onkologie und Immunologie, Universitätsklinikum Marburg, Marburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Sohlbach
authors.affiliation: University Hospital Brno, Brno, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Mayer
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Middeke
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Platzbecker
authors.affiliation: Klinik für Hämatologie und Onkologie, Rems-Murr-Kliniken, Winnenden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schaich
authors.affiliation: Abteilung Innere Medizin V, Universität Heidelberg, Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Krämer
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Röllig
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schetelig
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bornhäuser
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Ehninger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D059785:Karyotype; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011123:Polyploidy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult