单体核型在急性髓系白血病中的预后意义

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 (7.0×10(9)/L vs 11.7×10(9)/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.