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Awan UA, Farooq N, Sarwar A, Jehangir HMS, Hashmi MS, Alamgir M, Waheed F, Khurram M, Ahmed H, Khattak AA, Afzal MS. Cytogenetic abnormalities in patients with hematological malignancies in Lahore city, Pakistan. BRAZ J BIOL 2021; 83:e249911. [PMID: 34669802 DOI: 10.1590/1519-6984.249911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/03/2021] [Indexed: 11/22/2022] Open
Abstract
Hematological and hematopoietic cells malignancies of the genes and hematopoietic cells are associated with the genetic mutation, often at the chromosomal level. The standard cytogenetic study is widely accepted as one of the main diagnostics and prognostic determinants in patients. Therefore, the current descriptive and cross-sectional study sought to determine the cytogenetic analysis of frequent hematological malignancies in Pakistan. A total of 202 peripheral bone marrow or blood samples from patients with benign and malignant hematological malignancy were taken using a conventional G-banding technique. Among enrolled patients, the mean age was 21.5 years ± 23.4, and gender-wise distribution showed a marked predominance of the male 147 (73%) population compared to the female 55 (27%). Patients in the age group (2-10 years) had the highest frequency, 48 (24%), of hematological neoplasms, followed by age (11-20 years) with 40 (20%). Normal karyotypes (46, XX/46, XY) was found in 51% (n=103) patients. Furthermore, the frequency of complex karyotype was 30 (15%), while normal was seen in 171 (85%) patients. Pre-B Acute Lymphoblastic Leukemia (Pre-B ALL) was the most prevalent malignancy of 66 (33%), followed by Chronic Myelogenous Leukemia (CML) of 41 (20%) and Acute Lymphocytic Leukemia of 29 (14%). Translocation was the most prevalent 50 (25%), followed by hypotriploidy 14 (7%) and monosomy 8 (4%) on chromosome aberration analysis. In addition, t(9:22) translocation was found to be 20 (10%) in CML, with the majority in the age group (31-40 years). This study recommends that karyotyping should be tested frequently in hematological conditions because it may provide insight into the relative chromosomal changes associated with particular malignancies.
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Affiliation(s)
- U A Awan
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - N Farooq
- Lahore Medical and Dental College, Lahore, Pakistan
| | - A Sarwar
- Gujranwala Medical College, Gujranwala, Punjab, Pakistan
| | | | - M S Hashmi
- Bahria International Hospital, Lahore, Pakistan
| | - M Alamgir
- Punjab Institute of Cardiology, School of Allied Health Sciences, Lahore, Pakistan
| | - F Waheed
- Punjab University, Department of Microbiology and Molecular Genetics, Lahore, Pakistan
| | - M Khurram
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - H Ahmed
- COMSATS University, Department of Biosciences, Islamabad, Pakistan
| | - A A Khattak
- The University of Haripur, Department of Medical Laboratory Technology, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - M S Afzal
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
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Ornellas MHF, Maioli MCP, de Lucena SBSG, Bastos EF, Chaves TS, de Melo KV, Ribeiro-Carvalho MDM, Liehr T, Alves G. Complex karyotype including ring chromosome 11 in a patient with acute myeloid leukemia: case report. SAO PAULO MED J 2018; 136:361-367. [PMID: 28832804 PMCID: PMC9881703 DOI: 10.1590/1516-3180.2016.0252150217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/15/2017] [Indexed: 02/02/2023] Open
Abstract
CONTEXT Complex karyotypes in acute myeloid leukemia (AML) are characterized by an overall low response rate with frequent relapses after clinical treatment. CASE REPORT Here, we describe the case of a 61-year-old obese female with clinically diagnosed AML who presented a complex karyotype involving an uncommon abnormality: ring chromosome 11. Immunophenotypic analysis confirmed the diagnosis. Classical and molecular cytogenetic analyses, using GTG banding and FISH (fluorescence in situ hybridization), revealed the presence of complex structural rearrangement involving r(11), add(12)(p13), der(5) and der(13). CONCLUSIONS Molecular cytogenetic analysis is suitable for better identification and characterization of chromosomal rearrangements in AML. Case reports like this, as well as population-based studies, are necessary for understanding the karyotypic changes that occur in humans.
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Affiliation(s)
- Maria Helena Faria Ornellas
- Associate Professor, Pathology Service, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | | | - Stella Beatriz Sampaio Gonçalves de Lucena
- Associate Professor, Hematology Service, Universidade do Estado do Rio de Janeiro (UERJ), and Postdoctoral Research, Research Coordination, Instituto Nacional de Câncer (INCA), Rio de Janeiro (RJ), Brazil.
| | - Elenice Ferreira Bastos
- Biologist, Hematology Department, Universidade do Estado do Rio de Janeiro (UERJ), and Supervisor, Medical Genetics Department, Instituto Fernandes Figueira (IFF), Rio de Janeiro (RJ), Brazil.
| | - Tatiana Silva Chaves
- Biologist, Hematology Service, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | - Karina Vieira de Melo
- Medical Sciences Master’s Student, Hematology Service, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | - Marilza de Moura Ribeiro-Carvalho
- Biologist and Postdoctoral Researcher, Pathology Department, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | - Thomas Liehr
- Biologist and Head of Molecular Cytogenetics Laboratory, Jena University Hospital, Friedrich Schiller University, Institute of Human Genetics, Thüringen, Germany.
| | - Gilda Alves
- Biologist and Professor, Universidade do Estado do Rio de Janeiro (UERJ), and Researcher, Research Coordination, Instituto Nacional de Câncer (INCA), Rio de Janeiro (RJ), Brazil.
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Waheed S, Hassan J, Naz M, Maqsood S, Abid M, Shan S, Nadeem M, Shamsi TS. Complex Karyotype in Hematological Diseases: A 6-Year Single Centre Study from Pakistan. JOURNAL OF ONCOLOGY 2018; 2018:2019239. [PMID: 29971104 PMCID: PMC6008829 DOI: 10.1155/2018/2019239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/30/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. MATERIALS AND METHODS A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. RESULTS Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leukemia (4%). Also we found few patients with acute promyelocytic leukemia, aplastic anemia , chronic myeloid leukemia, and diffuse large B cell Lymphoma possessing complex karyotype. Frequencies of different cytogenetic abnormalities were assessed with respect to disease as well as independently. Trisomy 21 was the most common chromosomal abnormality found in 28% of patients. CONCLUSION Complex karyotype was most frequently associated with myelodysplastic syndromes and acute myeloid leukemia. Trisomy 21 and deletion 5q were the commonest cytogenetic abnormalities found. We also assessed complex karyotype in benign diseases and detected one patient of aplastic anemia with complex karyotype. This is the first study highlighting the presence of complex karyotypes in hematological disorders in our region.
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Affiliation(s)
- Samra Waheed
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Jawad Hassan
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Maliha Naz
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Sidra Maqsood
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Madiha Abid
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Saira Shan
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Muhammad Nadeem
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
| | - Tahir S. Shamsi
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi, Pakistan
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Xu J, Huang B, Liu X, Zhang Y, Liu Y, Chen L, Luan Y, Li N, Chu X. Poor Prognosis in Acute Myeloid Leukemia Patients with Monosomal Karyotypes. Turk J Haematol 2017; 34:126-130. [PMID: 27751980 PMCID: PMC5440863 DOI: 10.4274/tjh.2016.0255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: This study aimed to investigate the clinical characteristics and prognostic significance of monosomal karyotypes (MKs) in patients with acute myeloid leukemia (AML). Materials and Methods: We retrospectively analyzed the clinical data for 498 patients with AML, of whom 233 (46.8%) had an abnormal karyotype, including 42 with MKs (8.4%) and 70 with a complex karyotype (CK) (14.1%). Results: Patients with MKs were older (median age 62.5 vs. 52 years, p=0.003) and had lower median hemoglobin levels (62.5 vs. 77 g/L, p=0.009) and lower white blood cell counts (7.0×109/L vs. 11.7×109/L, p=0.008). Univariate analysis showed that patients with MKs or CKs had shorter overall survival than patients without these karyotypes (median survival time 7.3 vs. 26.3 months for MK, p<0.001, and 14.8 vs. 26.3 months for CK, p<0.001). In multivariable analysis for overall survival, MK and National Comprehensive Cancer Network prognostic group were the only significant factors. Conclusion: MK is an independent risk factor for poor prognosis in AML patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xiaoxia Chu
- Qindao University Medical College, Affiliated Yantai Yuhuangding Hospital, Department of Hematology, Yantai, China Phone: +86-535-6691999-82303 E-mail:
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Anelli L, Pasciolla C, Zagaria A, Specchia G, Albano F. Monosomal karyotype in myeloid neoplasias: a literature review. Onco Targets Ther 2017; 10:2163-2171. [PMID: 28461756 PMCID: PMC5404799 DOI: 10.2147/ott.s133937] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In 2008, the concept of the monosomal karyotype (MK) in adult acute myeloid leukemia (AML) patients was introduced, defined by the presence of a chromosomal aberration pattern characterized by the presence of at least two autosomal monosomies or of one monosomy plus one or more structural aberrations (not including loss of a chromosome). We present a systematic review of the literature about the influence of the MK on the outcome of patients affected by myeloid malignancies (AML, myelodysplastic syndromes, and primary myelofibrosis). For this review, a comprehensive literature search using the term “monosomal karyotype” was performed, considering articles listed in MEDLINE. This analysis of the literature confirms the negative prognostic impact on survival of the MK in myeloid neoplasias. The detrimental effect of MK on AML patients’ outcome is independent of other variables, including adverse cytogenetic features, supporting the identification of this entity as a challenging subgroup of patients with distinct biologic and clinical features.
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Affiliation(s)
- Luisa Anelli
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Crescenza Pasciolla
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Antonella Zagaria
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Giorgina Specchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Francesco Albano
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
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Sultan S, Zaheer HA, Irfan SM, Ashar S. Demographic and Clinical Characteristics of Adult Acute Myeloid Leukemia--Tertiary Care Experience. Asian Pac J Cancer Prev 2016; 17:357-60. [PMID: 26838237 DOI: 10.7314/apjcp.2016.17.1.357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is an acquired clonal frequent malignant disorder of myeloid progenitor cells. Our aim was to study demographical and clinicopathological features of adult Pakistani AML patients at presentation. MATERIALS AND METHODS In this single centre study extending from January 2010 to December 2014, data were retrieved from the patient records with a predetermined performa and analyzed with SPSS version 22. RESULTS Overall 125 patients were diagnosed at our institution with de novo AML during the study period. There were 76 males and 49 females (ratio 1.5:1), with an age range between 15 and 85 years and a mean age of 38.8±20.1 years. The major complaints were fever (72.8%), generalized weakness (60%), bleeding (37.6%) and dyspnea (12%). Physical examination revealed pallor in 56.8%, splenomegaly and hepatomegaly in 16% and 12.8%, respectively, and lymphodenopathy in 10.4%. The mean hemoglobin was 8.19±2.12g/dl with a mean MCV of 86.0±9.83 fl, a mean total leukocyte count of 43.1±68.5x109/l, an ANC of 3.09±6.66x109/l and a mean platelet count of 62.3±78.6x109/l. CONCLUSIONS AML in Pakistani patients is seen in a relatively very young population with male preponderance, compared with the west. However, clinico-pathological features appear comparable to published data.
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Affiliation(s)
- Sadia Sultan
- Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College, Karachi, Pakistan E-mail :
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7
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Monosomal karyotype of chromosome 5/7 was an independent poor prognostic factor for Chinese myelodysplastic syndrome patients. Cancer Genet 2016; 209:423-429. [DOI: 10.1016/j.cancergen.2016.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/02/2016] [Accepted: 06/14/2016] [Indexed: 12/14/2022]
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Gao S, Li Z, Fu JH, Hu XH, Xu Y, Jin ZM, Tang XW, Han Y, Chen SN, Sun AN, Wu DP, Qiu HY. Decitabine in the Treatment of Acute Myeloid Leukemia and Myelodysplastic Syndromes, Which Combined with Complex Karyotype Respectively. Asian Pac J Cancer Prev 2016; 16:6627-32. [PMID: 26434886 DOI: 10.7314/apjcp.2015.16.15.6627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We conducted a study exploring the clinical safety and efficacy of decitabine in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), combined with a complex karyotype. MATERIALS AND METHODS From April 2009 to September 2013, a total of 35 patients with AML/MDS combined with a complex karyotype diagnosed in the First Affiliated Hospital of Soochow University were included for retrospective analysis. All patients were treated with decitabine alone (20 mg/m2 daily for 5 days) or combination AAG chemotherapy (Acla 20 mg qod*4d, Ara-C 10 mg/m2 q12h*7d, G-CSF 300 μg qd, the dose of G-CSF adjusted to the amount in blood routinely). RESULTS In 35 patients, 15 exhibited a complete response (CR), and 6 a partial response (PR), the overall response rate (CR+PR) being 60% (21 of 35). Median disease-free survival was 18 months and overall survival was 14 months. In the 15 MDS patients with a complex karyotype, the CR rate was 53.3% (8 of 15); in 20 AML patients with complex karyotype, the overall response rate was 65% (13 of 20). The response rate of decitabine alone (22 cases) was 56.5% (13 of 22), while in the combination chemotherapy group (13 cases), the effective rate was 61.5% (8 of 13)(P>0.05). There are 15 patients with chromosome 7 aberration, after treatment with decitabine, 7 CR, 3 PR, overall response rate was 66.7% (10 of 15). Of 18 patients with 3 to 5 kinds of chromosomal abnormalities, 66.7% demonstrated a response; of 17 with more than 5 chromosomal abnormalities, 52.9% had a response. In the total of 35 patients, with one course (23 patients) and ≥two courses (12 patients), the overall response rate was 40.9% and 92.3% (P<0.05). Grade III to IV hematological toxicity was observed in 27 cases (75%). Grade III to IV infections were clinically documented in 7 (20%). Grades I to II non-hematological toxicity were infections (18 patients), haematuria (2 patients), and bleeding (3 patients). With follow-up until September 2013, 7 patients were surviving, 18 had died and 10 were lost to follow-up. In the 6 cases who underwent allogeneic hematopoietic stem cell transplantation (HSCT) all were still relapse-free survivors. CONCLUSIONS Decitabine alone or combination with AAG can improve outcome of AML/MDS with a complex karyotype, there being no significant difference decitabine in inducing remission rates in patients with different karyotype. Increasing the number of courses can improve efficiency. This approach with fewer treatment side effects in patients with a better tolerance should be employed in order to create an improved subsequent chance for HSCT.
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Affiliation(s)
- Su Gao
- Leukemia Research Division, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of the Ministry of Health, First Affiliated Hospital of Soochow University, Suzhou, China E-mail :
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9
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Mutations of myelodysplastic syndromes (MDS): An update. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 769:47-62. [DOI: 10.1016/j.mrrev.2016.04.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/11/2016] [Indexed: 01/08/2023]
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10
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Sultan S, Zaheer HA, Irfan SM, Ashar S. Acute Myeloid Leukemia: Clinical Spectrum of 125 Patients. Asian Pac J Cancer Prev 2016; 17:369-72. [PMID: 26838239 DOI: 10.7314/apjcp.2016.17.1.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia is an acquired clonal heterogeneous stem cell disorder. Hence, various parameters are sought out to categorize this disease into subtypes, so that as a consequence specific treatment modalities can be offered. Conventionally, the practically used method for classification utilizes French American British (FAB) criteria based on morphology and cytochemistry. The aim of present study was to determine the current spectrum of AML sub types in patients in Karachi. MATERIALS AND METHODS This single centre cross sectional study was conducted at Liaquat National Hospital, Karachi, extending from January 2010 to December 2014. Data were retrieved from archives were analyzed with SPSS version 22. RESULTS A total of 125 patients were diagnosed at our institution with de novo AML during five years period, 76 males and 49 females. Median age was 34.5 years. AML-M1 was the predominant FAB subtype (23.2%) followed by M2 (18.4%), M3 and M4 (16% each), M0 (14.4%), M5 (7.2%), M6 (3.2%) and M7 (1.6%). CONCLUSIONS AML in Pakistani patients is seen in a relatively young population. The most common FAB subtype observed in our study was acute myeloblastic leukemia, without maturation (M1).
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Affiliation(s)
- Sadia Sultan
- Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College, Karachi, Pakistan E-mail :
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Pasquini MC, Zhang MJ, Medeiros BC, Armand P, Hu ZH, Nishihori T, Aljurf MD, Akpek G, Cahn JY, Cairo MS, Cerny J, Copelan EA, Deol A, Freytes CO, Gale RP, Ganguly S, George B, Gupta V, Hale GA, Kamble RT, Klumpp TR, Lazarus HM, Luger SM, Liesveld JL, Litzow MR, Marks DI, Martino R, Norkin M, Olsson RF, Oran B, Pawarode A, Pulsipher MA, Ramanathan M, Reshef R, Saad AA, Saber W, Savani BN, Schouten HC, Ringdén O, Tallman MS, Uy GL, Wood WA, Wirk B, Pérez WS, Batiwalla M, Weisdorf DJ. Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies. Biol Blood Marrow Transplant 2016; 22:248-257. [PMID: 26327629 PMCID: PMC4716890 DOI: 10.1016/j.bbmt.2015.08.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 08/15/2015] [Indexed: 11/22/2022]
Abstract
The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+ AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.
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Affiliation(s)
- Marcelo C Pasquini
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bruno C Medeiros
- Department of Hematology, Stanford University School of Medicine, Stanford, California
| | - Philippe Armand
- Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Zhen-Huan Hu
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Mahmoud D Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - Görgün Akpek
- Stem Cell Transplantation and Cellular Therapy Program, Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Jean-Yves Cahn
- Department of Hematology, University Hospital, Grenoble, France
| | - Mitchell S Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Jan Cerny
- Department of Medicine, UMass Memorial Medical Center, Worcester, Massachusetts
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Abhinav Deol
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - César O Freytes
- Division of Hematology & Oncology, South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Siddhartha Ganguly
- Blood and Marrow Transplantation, Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, Kansas
| | - Biju George
- Department of Haematology, Christian Medical College, Vellore, India
| | - Vikas Gupta
- Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Gregory A Hale
- Department of Hematology/Oncology, All Children's Hospital, St. Petersburg, Florida
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Thomas R Klumpp
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Hillard M Lazarus
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Selina M Luger
- Department of Medicine, Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic, Rochester, Minnesota
| | - David I Marks
- Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maxim Norkin
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Betul Oran
- Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Attaphol Pawarode
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Ran Reshef
- Department of Medicine, Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Ayman A Saad
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands
| | - Olle Ringdén
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allogeneic Stem Cell Transplantation, Stockholm, Sweden
| | - Martin S Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Geoffrey L Uy
- Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - William A Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Waleska S Pérez
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Minoo Batiwalla
- Hematology Branch, National Heart Lung and Blood Institute - National Institutes of Health, Bethesda, Maryland
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
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Luan Y, Xu J, Huang B, Liu X, Liu Y, Chen L, Chu X. [Prognostic significance of monosomal karyotype in acute myeloid leukemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2016; 36:286-90. [PMID: 25916287 PMCID: PMC7342614 DOI: 10.3760/cma.j.issn.0253-2727.2015.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the prognostic significance of monosomal karyotype (MK) in patients with acute myeloid leukemia (AML). METHODS The clinical data of 498 AML patients were analyzed retrospectively. RESULTS Of the 498 patients, 233 (46.8%) cases had an abnormal karyotype. 42 patients fulfilled the criteria for MK, which were 8.4% of all cases and 18.0% of patients with abnormal karyotype, respectively. The most frequent autosomal monosomies were -7 and -17. 70 patients had complex karyotype (CK), in all patients and patients with abnormal karyotype accounted for 14.1% and 30.0%, respectively. Patients with MK were associated with significantly older (median age 62.5 vs 52 years, P=0.003), and lower HGB concentrations (62.5 vs 77 g/L, P=0.009) and lower WBC counts (7.0×10⁹/L vs 11.7×10⁹/L, P=0.008). Among MK cases, the most frequent chromosome abnormalities were complex karyotype, -7, -5, 7q-, and 5q-. In univariate analysis, MK patients had worse survival than those without MK (7.3 months vs 26.3 months, P<0.001). CK patients also had poorer outcomes than patients without CK (14.8 months vs 26.3 months, P<0.001). In CK patients, survival was worse in MK patients than patients without MK (7.4 months vs 19.2 months, P=0.007). By COX analysis, MK was an independent prognostic factor, beyond NCCN criteria and CK [HR=2.610 (1.632-4.175), P<0.001]. CONCLUSION MK was an independent adverse prognostic factor in AML patients.
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Affiliation(s)
- Yanyan Luan
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Junqing Xu
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Baohua Huang
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Xiaoqian Liu
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Yinghui Liu
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Liming Chen
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
| | - Xiaoxia Chu
- Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China
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Lu QS, Xu N, Zhou X, Huang JX, Li L, Li YL, Lu ZY, Cao R, Liao LB, Liu XL. Prognostic Significance of Monosomal Karyotype in Adult Patients With Acute Myeloid Leukemia Treated With Risk-Adapted Protocols. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:790-6. [PMID: 26482108 DOI: 10.1016/j.clml.2015.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/01/2015] [Accepted: 09/11/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND The monosomal karyotype (MK) is a well-known adverse prognostic factor and has been found to be related to poor outcome in patients with acute myeloid leukemia (AML). However, the outcome in MK-positive AML patients undergoing different therapies has not been well investigated. PATIENTS AND METHODS We retrospectively analyzed clinical and laboratory features in 225 MK-positive AML patients. Clinical outcome of overall survival (OS) and disease-free survival (DFS) was evaluated in patients according to age group and in patients who received different therapy protocols. RESULTS The proportion of MK-positive patients increased along with age. Also, patients who were treated with high-dose cytarabine (HD-Ara-C) as consolidation therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) demonstrated longer OS and DFS compared to allo-HSCT or HD-Ara-C alone. Patients treated with allo-HSCT alone exhibited longer DFS compared to patients treated with HD-Ara-C alone. No difference in OS was discovered between these 2 single protocols. CONCLUSION MK was associated with a lower complete remission rate. HD-Ara-C therapy followed by allo-HSCT could improve the prognosis of MK-positive AML patients.
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Affiliation(s)
- Qi-Si Lu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Na Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Xuan Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Ji-Xian Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Lin Li
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Yu-Ling Li
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Zi-Yuan Lu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Rui Cao
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Li-Bin Liao
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China
| | - Xiao-Li Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou, China.
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Motlló C, Ribera JM, Morgades M, Granada I, Montesinos P, González-Campos J, Fernández-Abellán P, Tormo M, Bethencourt C, Brunet S, Hernández-Rivas JM, Moreno MJ, Sarrà J, del Potro E, Barba P, Bernal T, Grande C, Grau J, Cervera J, Feliu E. Prognostic significance of complex karyotype and monosomal karyotype in adult patients with acute lymphoblastic leukemia treated with risk-adapted protocols. Cancer 2014; 120:3958-64. [DOI: 10.1002/cncr.28950] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/06/2014] [Accepted: 06/25/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Cristina Motlló
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
| | - Josep-María Ribera
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
| | - Mireia Morgades
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
| | - Isabel Granada
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
| | - Pau Montesinos
- Department of Hematology; Hospital Universitario y Politécnico La Fe; Valencia Spain
| | | | | | - Mar Tormo
- Department of Hematology; Hospital Clínico Universitario; Valencia Spain
| | | | - Salut Brunet
- Department of Hematology; Hospital de Sant Pau; Barcelona Spain
| | | | - María-José Moreno
- Department of Hematology; Hospital Clínico Universitario Virgen de la Victoria; Málaga Spain
| | - Josep Sarrà
- Department of Hematology; ICO-Hospital Duran i Reynals, L'Hospitalet del Llobregat; Spain
| | - Eloy del Potro
- Department of Hematology; Hospital Clínico San Carlos; Madrid Spain
| | - Pere Barba
- Department of Hematology; Hospital Vall d'Hebron; Barcelona Spain
| | - Teresa Bernal
- Department of Hematology; Hospital Universitario Central; Asturias Spain
| | - Carlos Grande
- Department of Hematology; Hospital 12 de Octubre; Madrid Spain
| | - Javier Grau
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
| | - José Cervera
- Department of Hematology; Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - Evarist Feliu
- Department of Hematology; ICO-Hospital Germans Trias i Pujol.Josep Carreras Leukemia Research Institute; Badalona Spain
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