Incidence and prognostic significance of karyotypic subgroups in older patients with acute myeloid leukemia: the Swedish population-based experience

Abstract

The Swedish population-based acute myeloid leukemia registry contains data from 3251 patients (excluding acute promyelocytic leukemia) diagnosed between 1997 and 2006. Informative cytogenetic data from 1893 patients were retrospectively added, including 1054 patients aged between 60 and 79 years. Clonal abnormalities were found in 57% of the informative karyotypes. Karyotypic patterns differed by age: t(8;21), inv(16) and t(11q23) were more common in younger patients, whereas loss of 5q, 7q and 17p, monosomal karyotype (MK) and complex karyotypes were more common in older patients. Loss of 5q, 7q and 17p often occurred together within MK. Patients with ⩾5 chromosome abnormalities had worse overall survival than those with fewer abnormalities or normal karyotype in all age groups. Loss of 5q, 7q and/or 17p had, in contrast to MK, a further negative impact on survival. Multivariable Cox regression analyses on risk factors in patients <80 years with cytogenetic abnormalities and intensive treatment revealed that age and performance status had the most significant impact on survival (both P<0.001), followed by sex (P=0.0135) and a karyotype including −7/del(7q) (P=0.048).

Incidence, Survival, and Risk Factors for Adults with Acute Myeloid Leukemia Not Otherwise Specified and Acute Myeloid Leukemia with Recurrent Genetic Abnormalities: Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database, 2001–2013

“…We observed a similar number of cases of AML inv(16)(p13.1q22)/t(16; 16)(p13.1;q22) and AML t(8; 21)(q22;q22) (388 and 495 cases, respectively, among 16,328). These results are consistent with those of other groups who studied predominantly white populations in Sweden and Australia [24-26]. In contrast, studies of Asian populations found 3–7 times more cases of AML t(8; 21)(q22;q22) than of AML inv(16)(p13.1q22)/t(16; 16)(p13.1;q22) [25-27].…”

Monosomal karyotype in myeloid neoplasias: a literature review

“…These results demonstrate that the MK is a major independent very poor prognosis factor in elderly AML. During the past few years, several large studies have been conducted to analyze the prognostic impact of the MK on the outcome of AML (summarized in Table 1), confirming the previously reported findings 1,5,9–13,17–24. Moreover, a recent report demonstrated that the combination of CK (defined in this study as unrelated chromosomal abnormalities ≥4) and the MK missed the least number of patients with unfavorable prognosis 18…”

Cytogenetic Profile in 7209 Indian Patients with &lt;i&gt;de novo&lt;/i&gt; Acute Leukemia: A Single Centre Study from India

“…In the present study, the median age of adult AML was lower (38 years) in comparison to Western population (40 -45 years) and other Asian population [6] [8] [9] [31]- [34] [41]. In adult AML, the incidence of t(8;21) was higher (15%) than that of Western population (6% -8%) and comparable to that in Chinese (8% -15%) and Japanese (16%) populations [3] [46].…”