Nazha Aziz, Kantarjian Hagop M, Bhatt Vijaya R, Nogueras-Gonzalez Graciela, Cortes Jorge E, Kadia Tapan, Garcia-Manero Guillermo, Abruzzo Lynne, Daver Naval, Pemmaraju Naveen, Quintas-Cardama Alfonso, Ravandi Farhad, Keating Michael, Borthakur Gautam
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Clin Lymphoma Myeloma Leuk. 2014 Apr;14(2):163-71. doi: 10.1016/j.clml.2013.07.009. Epub 2014 Jan 22.
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.
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.
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 CK 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).
Among patients with CK-AML, MK was associated with poor outcomes. Additional presence of C17 abns further worsens the outcome in these particularly poor-risk patients with AML.
17号染色体异常与包括急性髓系白血病（AML）在内的白血病预后不良相关。最近，髓系细胞触发受体-1（MK）被引入作为AML预后不良的独立预测指标。在细胞角蛋白（CK）背景下，17号染色体异常（C17 abns）对伴有MK的患者的额外预后影响尚不清楚。
我们对1998年1月至2007年12月期间接受治疗的1086例新诊断AML患者进行了回顾性分析。患者接受了该机构一线方案之一的治疗。
483例患者有CK。其中，370例患者（77%）有CK-MK，195例患者（53%）有CK-MK-C17 abns。与没有MK的CK患者相比，CK-MK患者的总生存期（OS）明显更短（分别为4.4个月和8个月；P = 0.002）。CK-C17 abns患者的中位OS短于没有C17 abns的患者（分别为4个月和6.1个月；P = 0.004）。在多变量分析中，CK患者中MK的存在被确定为OS的独立预后标志物。此外，C17 abns的存在对CK-MK患者的OS有显著负面影响（P = 0.04）。
在CK-AML患者中，MK与不良预后相关。C17 abns的额外存在进一步恶化了这些AML高危患者的预后。
