Luan Yanyan, Xu Junqing, Huang Baohua, Liu Xiaoqian, Liu Yinghui, Chen Liming, Chu Xiaoxia
Department of Hematology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China.
Zhonghua Xue Ye Xue Za Zhi. 2015 Apr;36(4):286-90. doi: 10.3760/cma.j.issn.0253-2727.2015.04.005.
To explore the prognostic significance of monosomal karyotype (MK) in patients with acute myeloid leukemia (AML).
The clinical data of 498 AML patients were analyzed retrospectively.
Of the 498 patients, 233 (46.8%) cases had an abnormal karyotype. 42 patients fulfilled the criteria for MK, which were 8.4% of all cases and 18.0% of patients with abnormal karyotype, respectively. The most frequent autosomal monosomies were -7 and -17. 70 patients had complex karyotype (CK), in all patients and patients with abnormal karyotype accounted for 14.1% and 30.0%, respectively. Patients with MK were associated with significantly older (median age 62.5 vs 52 years, P=0.003), and lower HGB concentrations (62.5 vs 77 g/L, P=0.009) and lower WBC counts (7.0×10⁹/L vs 11.7×10⁹/L, P=0.008). Among MK cases, the most frequent chromosome abnormalities were complex karyotype, -7, -5, 7q-, and 5q-. In univariate analysis, MK patients had worse survival than those without MK (7.3 months vs 26.3 months, P<0.001). CK patients also had poorer outcomes than patients without CK (14.8 months vs 26.3 months, P<0.001). In CK patients, survival was worse in MK patients than patients without MK (7.4 months vs 19.2 months, P=0.007). By COX analysis, MK was an independent prognostic factor, beyond NCCN criteria and CK [HR=2.610 (1.632-4.175), P<0.001].
MK was an independent adverse prognostic factor in AML patients.
探讨单倍体核型（MK）在急性髓系白血病（AML）患者中的预后意义。
回顾性分析498例AML患者的临床资料。
498例患者中，233例（46.8%）核型异常。42例符合MK标准，分别占所有病例的8.4%和核型异常患者的18.0%。最常见的常染色体单体是-7和-17。70例患者有复杂核型（CK），在所有患者及核型异常患者中分别占14.1%和30.0%。MK患者年龄显著较大（中位年龄62.5岁对52岁，P=0.003），血红蛋白浓度较低（62.5对77 g/L，P=0.009），白细胞计数较低（7.0×10⁹/L对11.7×10⁹/L，P=0.008）。在MK病例中，最常见的染色体异常是复杂核型、-7、-5、7q-和5q-。单因素分析显示，MK患者的生存期比无MK患者差（7.3个月对26.3个月，P<0.001）。CK患者的预后也比无CK患者差（14.8个月对26.3个月，P<0.001）。在CK患者中，MK患者的生存期比无MK患者差（7.4个月对19.2个月，P=0.007）。通过COX分析，MK是一个独立的预后因素，超出了NCCN标准和CK [风险比=2.610（1.632 - 4.175），P<0.001]。
MK是AML患者独立的不良预后因素。
