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The impact of concomitant cytogenetic abnormalities on acute myeloid leukemia with monosomy 7 or deletion 7q after HLA‐matched allogeneic stem cell transplantation
Author(s) -
Poiré Xavier,
Labopin Myriam,
Polge Emmanuelle,
Volin Liisa,
Finke Jürgen,
Ganser Arnold,
Blaise Didier,
YakoubAgha Ibrahim,
Beelen Dietrich,
Forcade Edouard,
Lioure Bruno,
Socié Gérard,
Niederwieser Dietger,
LabussièreWallet Hélène,
Maertens Johan,
Cornelissen Jan,
Craddock Charles,
Mohty Mohamad,
Esteve Jordi,
Nagler Ar
Publication year - 2020
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25714
Subject(s) - monosomy , myeloid leukemia , medicine , transplantation , cytogenetics , leukemia , hematopoietic stem cell transplantation , oncology , karyotype , chromosome 7 (human) , myelodysplastic syndromes , gastroenterology , biology , immunology , bone marrow , genetics , chromosome , gene
Abstract Monosomy 7 or deletion 7q (‐7/7q‐) is the most frequent adverse cytogenetic features reported in acute myeloid leukemia (AML), and is a common indication for allogeneic stem cell transplantation (SCT). Nevertheless, ‐7/7q‐ occurs frequently with other high‐risk cytogenetic abnormalities such as complex karyotype (CK), monosomal karyotype (MK), monosomy 5 or deletion 5q (‐5/5q‐), 17p abnormalities (abn(17p)) or inversion of chromosome 3 (inv(3)), the presence of which may influence the outcomes after SCT. A total of 1109 patients were allocated to this study. Two‐year probability of leukemia‐free survival (LFS) and overall survival (OS) were 30% and 36%, respectively. Two‐year probability of non‐relapse mortality (NRM) was 20%. We defined five different cytogenetic subgroups: the “‐7/7q‐ ± CK group‐ designated group1,” the “MK group‐designated group 2,” the “‐5/5q‐ group‐ designated group 3,” the “abn(17p) group‐ designated group 4” and the “inv(3) group‐ designated group 5.” The 2‐year probability of LFS in first remission was 48% for group 1, 36.4% for group 2, 28.4% for group 3, 19.1% for group 4 and 17.3% for group 5, respectively ( P < .001). Multivariate analysis confirmed those significant differences across groups. Note, SCT in ‐7/7q‐ AML provides durable responses in one third of the patients. The presence of ‐7/7q‐ with or without CK in the absence of MK, abn(17p) or inv(3) is associated with a better survival after SCT. On the contrary, addition of MK, ‐5/5q‐, abn(17p) or inv(3) identifies a sub‐group of patients with poor prognosis even after SCT.