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Original Articles: Clinical

Concomitance of monosomal karyotype with at least 5 chromosomal abnormalities is associated with dismal treatment outcome of AML patients with complex karyotype – retrospective analysis of Polish Adult Leukemia Group (PALG)

Agnieszka WierzbowskaDepartment of Hematology, Medical University of Lodz, Lodz, Poland; Correspondence[email protected]

Ewa WawrzyniakDepartment of Hematology, Medical University of Lodz, Lodz, Poland;

Monika Siemieniuk-RysDepartment of Hematology, Copernicus Memorial Hospital, Lodz, Poland;

Aleksandra KotkowskaDepartment of Hematology, Copernicus Memorial Hospital, Lodz, Poland;

Agnieszka PlutaDepartment of Hematology, Medical University of Lodz, Lodz, Poland;

Aleksandra GolosDepartment of Hematology, Copernicus Memorial Hospital, Lodz, Poland;

Tadeusz RobakDepartment of Hematology, Medical University of Lodz, Lodz, Poland;

Marta SzarawarskaDepartment of Hematology, Blood Malignancies and Bone Marrow Transplantation, Medical University of Wroclaw, Wroclaw, Poland;

Anna JaskowiecDepartment of Hematology, Blood Malignancies and Bone Marrow Transplantation, Medical University of Wroclaw, Wroclaw, Poland;

Ewa DuszenkoDepartment of Hematology, Blood Malignancies and Bone Marrow Transplantation, Medical University of Wroclaw, Wroclaw, Poland;

Justyna RybkaDepartment of Hematology, Blood Malignancies and Bone Marrow Transplantation, Medical University of Wroclaw, Wroclaw, Poland;

Jadwiga HolojdaDepartment of Hematology, WSS, Legnica, Poland;

Sebastian GrosickiDepartment of Hematology, ZSM of Chorzow, Chorzow, Poland;

Barbara Pienkowska-GrelaCancer Genetics Laboratory of Pathology Department, M Sklodowska-Curie Memorial Cancer Center and Institute, Warsaw, Poland;

Renata WoronieckaCancer Genetics Laboratory of Pathology Department, M Sklodowska-Curie Memorial Cancer Center and Institute, Warsaw, Poland;

Anna EjdukDepartment of Hematology, Institute of Hematology and Blood Transfusion, Warsaw, Poland;

Marzena WatekDepartment of Hematology, Holycross Cancer Center, Kielce, Poland;

Malgorzata WachDepartment of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland;

Barbara MuchaDepartment of Clinical Genetics, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland;

Katarzyna SkonieczkaDepartment of Clinical Genetics, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland;

Maria CzyzewskaDepartment of Hematology, Nicolaus Copernicus Municipal Specialist Hospital, Torun, Poland;

Anna JachalskaDepartment of Hematology, Medical University of Bydgoszcz, Bydgoszcz, Poland;

Agnieszka KlonowskaDepartment of Biology and Genetics, Medical University of Gdansk, Gdansk, Poland;

Mariola IliszkoDepartment of Biology and Genetics, Medical University of Gdansk, Gdansk, Poland;

Wanda Knopinska-PoslusznyDepartment of Hematology, SP ZOZ WMCO Oncology Center, Olsztyn, Poland;

Malgorzata Jarmuz-SzymczakInstitute of Human Genetics, PAN, Poznan, Poland; ;Department of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland;

Anna Przybylowicz-ChaleckaDepartment of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland;

Lidia GilDepartment of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland;

Agnieszka KopaczDepartment of Hematology, Oncology Center, Municipal Hospital, Rzeszow, Poland;

Jerzy HolowieckiDepartment of Bone Marrow Transplantation, M. Sklodowska-Curie Institute of Oncology, Gliwice, Poland

Olga HausDepartment of Hematology, Blood Malignancies and Bone Marrow Transplantation, Medical University of Wroclaw, Wroclaw, Poland; ;Department of Clinical Genetics, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland;

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Abstract

Monosomal karyotype (MK) and complex karyotype (CK) are poor prognostic factors in acute myeloid leukemia (AML). A comprehensive analysis of cytogenetic and clinical factors influencing an outcome of AML-CK⁺ was performed. The impact of cladribine containing induction on treatment results was also evaluated. We analyzed 125 patients with AML-CK⁺ treated within PALG protocols. MK was found in 75 (60%) individuals. The overall complete remission (CR) rate of 66 intensively treated patients was 62% vs. 28% in CK⁺ MK⁻ and CK⁺ MK⁺ group (p = .01). No difference in CR rate was observed between DA and DAC arms. The overall survival (OS) in intensively treated patients was negatively influenced by MK, karyotype complexity (≥5 abnormalities), and WBC >20 G/L in multivariate analysis. The addition of cladribine to DA regimen improved OS only in MK⁻ but not in MK⁺ group. In conclusion, concomitance of MK with ≥5 chromosomal abnormalities is associated with dismal treatment outcome in AMK-CK⁺.

Keywords:

Acknowledgements

This work was supported in part by a grant from Medical University of Lodz [grant No. 503/1-093-01/503-11-003].

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online. http://dx.doi.org/10.1080/10428194.2016.1219901.

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Concomitance of monosomal karyotype with at least 5 chromosomal abnormalities is associated with dismal treatment outcome of AML patients with complex karyotype – retrospective analysis of Polish Adult Leukemia Group (PALG)

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Concomitance of monosomal karyotype with at least 5 chromosomal abnormalities is associated with dismal treatment outcome of AML patients with complex karyotype – retrospective analysis of Polish Adult Leukemia Group (PALG)

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