Contributions
Type: Publication Only
Background
It has been shown previously that monosomal karyotype (MK) is associated with bad prognosis in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). At the same time there are ambiguous data about relationship of MK with other clinical and biological features of AML and MDS.
Aims
To characterize clinical, morphological and cytogenetic signs of AML and MDS patients that are associated with MK.
Methods
A retrospective analysis of 44 patients with AML and 33 patients with MDS was done. To diagnose AML and MDS the criteria of WHO classification was used. Karyotype was studied by standard method. The cases with t(8;21), t(15;17), and inv(16) were excluded from the analyses.
Results
The median age of AML and MDS patients was 64 (17-84) y and 63 y (28-81), accordingly. Number of patients with therapy-related AML and MDS was 11.4% and 12.1%, accordingly. In the MDS group there were 3 (9.1%) patients without excess of bone marrow (BM) blasts and 30 patients had ≥5% BM blasts. So the ratio was 1:10. The most frequent monosomies were -5, -7, and -18 regardless of the diseases. The number of monosomies in individual patients was ranged from 1 till 7. In the AML group the number of cases with ≥3 monosomies was more frequent event in patients ≥60 y than in patients <60 y: 46.4% vs 18.7%; p=0.02. There was correlation between the number of monosomies and AML patients’ age: r=0.308; p<0.05. Specific CD expression different from the typical myeloid blasts’ phenotype was not found. Median overall survival (OS) of AML and MDS patients were 6 and 8 months, accordingly. Nevertheless there were some long-liver patients: 4 with AML (12-171 mo) and 2 with MDS (20, 38 mo). Three of the AML patients were treated with chemotherapy only and the period of follow-up without relapse were 52, 119 and 171 months. Their karyotype did not characterize by any iterant chromosomal aberration. AlloSCT was realized to the fourth AML patient. Long-liver MDS patients had variant without excess of BM blasts and died after AML transformation or pancytopenia’s intensification.
Summary
Monosomal karyotype is the cytogenetic finding that is not associated with patients’ age, negative influence of the previous therapy or specific CD expression on the BM blast. But it may be more often event in the group of advanced MDS. AML patients with monosomal karyotype have to be treated aggressively as there is a chance of long relapse-free and OS after standard intensive chemotherapy.
Type: Publication Only
Background
It has been shown previously that monosomal karyotype (MK) is associated with bad prognosis in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). At the same time there are ambiguous data about relationship of MK with other clinical and biological features of AML and MDS.
Aims
To characterize clinical, morphological and cytogenetic signs of AML and MDS patients that are associated with MK.
Methods
A retrospective analysis of 44 patients with AML and 33 patients with MDS was done. To diagnose AML and MDS the criteria of WHO classification was used. Karyotype was studied by standard method. The cases with t(8;21), t(15;17), and inv(16) were excluded from the analyses.
Results
The median age of AML and MDS patients was 64 (17-84) y and 63 y (28-81), accordingly. Number of patients with therapy-related AML and MDS was 11.4% and 12.1%, accordingly. In the MDS group there were 3 (9.1%) patients without excess of bone marrow (BM) blasts and 30 patients had ≥5% BM blasts. So the ratio was 1:10. The most frequent monosomies were -5, -7, and -18 regardless of the diseases. The number of monosomies in individual patients was ranged from 1 till 7. In the AML group the number of cases with ≥3 monosomies was more frequent event in patients ≥60 y than in patients <60 y: 46.4% vs 18.7%; p=0.02. There was correlation between the number of monosomies and AML patients’ age: r=0.308; p<0.05. Specific CD expression different from the typical myeloid blasts’ phenotype was not found. Median overall survival (OS) of AML and MDS patients were 6 and 8 months, accordingly. Nevertheless there were some long-liver patients: 4 with AML (12-171 mo) and 2 with MDS (20, 38 mo). Three of the AML patients were treated with chemotherapy only and the period of follow-up without relapse were 52, 119 and 171 months. Their karyotype did not characterize by any iterant chromosomal aberration. AlloSCT was realized to the fourth AML patient. Long-liver MDS patients had variant without excess of BM blasts and died after AML transformation or pancytopenia’s intensification.
Summary
Monosomal karyotype is the cytogenetic finding that is not associated with patients’ age, negative influence of the previous therapy or specific CD expression on the BM blast. But it may be more often event in the group of advanced MDS. AML patients with monosomal karyotype have to be treated aggressively as there is a chance of long relapse-free and OS after standard intensive chemotherapy.