Prognostic Implications of Chromosome 17 Abnormalities in the Context of Monosomal Karyotype in Patients With Acute Myeloid Leukemia and Complex Cytogenetics

Chromosome 17 abnormalities (C17 abns) and monosomal karyotype (MK) are associated with poor outcome in acute myeloid leukemia (AML). We conducted a retrospective analysis of 1086 patients with newly diagnosed AML to evaluate the additional prognostic effect of C17 abns in patients with MK and complex karyotype (CK) MK. Four hundred eighty-three patients had CK. Among them, 370 patients (77%) had CK-MK, and 195 patients (53%) had MK and C17 abns (CK-MK-C17 abns). Patients with CK-MK had significantly shorter overall survival (OS) rates compared with patients with CK without MK and the presence of C17 abns further worsens the outcome in these particularly poor-risk patients. Background: Chromosome 17 abnormalities are associated with poor outcome in leukemias including AML. Recently, MK was introduced as an independent predictor of dismal outcome in AML. The additional prognostic effect of C17 abns in patients with MK in a CK background is not clear. Patients and Methods: We conducted a retrospective analysis of 1086 patients with newly diagnosed AML treated between January 1998 and December 2007. Patients received treatment with one of the institution's first-line protocols. Results: Four hundred eighty-three patients had CK. Among them, 370 patients (77%) had CK-MK, and 195 patients (53%) had CK-MK-C17 abns. Patients with CK-MK had significantly shorter OS rates compared with patients with CK without MK (4.4 vs. 8 months, respectively; P = .002). The median OS for patients with CK-C17 abns was shorter than for patients without C17 abns (4 vs. 6.1 months, respectively; P = .004). In a multivariate analysis, the presence of MK among patients with OK was identified as an independent prognostic marker for OS. In addition, presence of C17 abns had a significant negative effect on OS among patients with CK-MK (P = .04). Conclusion: Among patients with CK-AML, MK was associated with poor outcomes. Additional presence of 017 abns further worsens the outcome in these particularly poor-risk patients with AML.