Cytogenetic risk stratification in chronic myelomonocytic leukemia

被引：208

作者：

Such, Esperanza ^{[4
]}

Cervera, Jose ^{[4
]}

Costa, Dolors ^{[1
]}

Sole, Francesc ^{[2
]}

Vallespi, Teresa ^{[3
]}

Luno, Elisa ^{[5
]}

Collado, Rosa ^{[6
]}

Calasanz, Maria J. ^{[7
]}

Hernandez-Rivas, Jesus M. ^{[8
]}

Cigudosa, Juan C. ^{[9
]}

Nomdedeu, Benet ^{[1
]}

Mallo, Mar ^{[2
]}

Carbonell, Felix ^{[6
]}

Bueno, Javier ^{[3
]}

Ardanaz, Maria T. ^{[10
]}

Ramos, Fernando ^{[11
]}

Tormo, Mar ^{[12
]}

Sancho-Tello, Reyes ^{[13
]}

del Canizo, Consuelo ^{[8
]}

Gomez, Valle ^{[14
]}

Marco, Victor ^{[15
]}

Xicoy, Blanca ^{[16
]}

Bonanad, Santiago ^{[17
]}

Pedro, Carmen ^{[2
]}

Bernal, Teresa ^{[5
]}

Sanz, Guillermo F. ^{[4
]}

机构：

[1] Hosp Clin Barcelona, Barcelona, Spain

[2] Hosp del Mar, Barcelona, Spain

[3] Hosp Univ Vall DHebron, Barcelona, Spain

[4] Hosp Univ La Fe, Valencia 46009, Spain

[5] Univ Oviedo, Hosp Cent Asturias, E-33080 Oviedo, Spain

[6] Hosp Gen Valencia, Valencia, Spain

[7] Univ Navarra, E-31080 Pamplona, Spain

[8] Hosp Univ Salamanca, Salamanca, Spain

[9] Ctr Nacl Invest Oncol, Madrid, Spain

[10] Hosp Txagorritxu, Vitoria, Spain

[11] IBIOMED Univ Leon, Leon, Spain

[12] Hosp Clin Univ, Valencia, Spain

[13] Hosp Arnau de Villanova, Valencia, Spain

[14] Hosp La Princesa, Madrid, Spain

[15] Hosp Arnau Vilanova, Lleida, Spain

[16] Hosp Badalona Germans Trias & Pujol, Badalona, Spain

[17] Hosp Ribera, Valencia, Spain

来源：

HAEMATOLOGICA-THE HEMATOLOGY JOURNAL | 2011年 / 96卷 / 03期

关键词：

chronic myelomonocytic leukemia; CMML; cytogenetics; SCORING SYSTEM; PROPOSALS; PROGNOSIS; SERIES;

D O I：

10.3324/haematol.2010.030957

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The prognostic value of cytogenetic findings in chronic myelomonocytic leukemia is unclear. Our purpose was to evaluate the independent prognostic impact of cytogenetic abnormalities in a large series of patients with chronic myelomonocytic leukemia included in the database of the Spanish Registry of Myelodysplastic Syndromes. Design and Methods We studied 414 patients with chronic myelomonocytic leukemia according to WHO criteria and with a successful conventional cytogenetic analysis at diagnosis. Different patient and disease characteristics were examined by univariate and multivariate methods to establish their relationship with overall survival and evolution to acute myeloid leukemia. Results Patients with abnormal karyotype (110 patients, 27%) had poorer overall survival (P=0.001) and higher risk of acute myeloid leukemia evolution (P=0.010). Based on outcome analysis, three cytogenetic risk categories were identified: low risk (normal karyotype or loss of Y chromosome as a single anomaly), high risk (presence of trisomy 8 or abnormalities of chromosome 7, or complex karyotype), and intermediate risk (all other abnormalities). Overall survival at five years for patients in the low, intermediate, and high risk cytogenetic categories was 35%, 26%, and 4%, respectively (P < 0.001). Multivariate analysis confirmed that this new CMML-specific cytogenetic risk stratification was an independent prognostic variable for overall survival (P=0.001). Additionally, patients belonging to the high-risk cytogenetic category also had a higher risk of acute myeloid leukemia evolution on univariate (P=0.001) but not multivariate analysis. Conclusions Cytogenetic findings have a strong prognostic impact in patients with chronic myelomonocytic leukemia.

引用

页码：375 / 383

页数：9