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Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype

 JE Jang ; YH Min ; J-W Cheong ; W-S Min ; J-S Ahn ; SK Park ; J Park ; SM Lee ; JS Chung ; JH Jang ; K-H Lee ; S Park ; H-J Kim ; D-S Hong ; JH Lee ; WS Lee ; H-J Shin ; CW Jung ; J-H Lee ; I Kim ; J Yoon 
 Blood Cancer Journal, Vol.5 : e358, 2015 
Journal Title
 Blood Cancer Journal 
Issue Date
Monosomal karyotype (MK) defined by either ⩾2 autosomal monosomies or single monosomy with at least one additional structural chromosomal abnormality is associated with a dismal prognosis in patients with acute myeloid leukemia (AML). It was detected in 174 of 3041 AML patients in South Korean Registry. A total of 119 patients who had received induction therapy were finally analyzed to evaluate the predictive factors for a positive prognosis. On multivariate analysis, single monosomy, the absence of abn(17p), ⩾10% of cells with normal metaphase and the achievement of a complete remission (CR) after induction therapy were significant factors for more favorable outcomes. Especially, single monosomy remained as a significantly independent prognostic factor for superior survival in both patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR and who did not. Allo-HSCT in CR improved overall survival significantly only in patients with a single monosomy. Our results suggest that MK-AML may be biologically different according to the karyotypic subtype and that allo-HSCT in CR should be strongly recommended to patients with a single monosomy. For other patients, more prudent treatment strategies should be examined. Furthermore, the biological mechanism by which a single monosomy influences survival should be investigated.
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