Monosomal karyotype as an adverse risk factor for inferior survivals in children with acute myeloid leukemia

Abstract

Background: Although monosomal karyotype (MK) has been recognized as an adverse risk factor in adult acute myeloid leukemia (AML), its impact on pediatric AML outcomes remains unclear. Methods: Clinical characteristics, cytogenetic and molecular profiling, and prognostic impact of MK were analyzed in a cohort of 284 children with AML in a Chinese population. Results: MK was present in 14 (4.5%) cases of the study cohort. MK-AML showed low prevalence of TP53 mutant and 17p13 aberrations. Children with MK-AML had shorter overall survival (OS) and event-free survival (EFS) compared to those with intermediate-risk features (OS: 26 ± 9.7% vs. 2 ± 1.5%, p < 0.001; EFS: 20 ± 7.4% vs. 1 ± 0.3%, p < 0.001) as well as adverse risk (OS: 15 ± 1.4% vs. 2 ± 1.5%, p = 0.012; EFS: 12 ± 1.6%, p = 0.014). Multivariate analysis demonstrated MK as an independent adverse risk factor for reduced survival (OS: HR 2.09, 95% CI 1.12–3.88, p = 0.02; EFS: HR 5.24, 95% CI 1.55–17.54, p = 0.08). Conclusions: The results show MK as an independent adverse risk factor for inferior survivals.

Keywords

• AML
• Pediatric
• Monosomal karyotype
• Mutation
• Survival