On a recent study that analyzed patients between 17 and 93 years of age (N = 1592), who were participants in the ECOG-ACRIN trials, the influence of the most common monosomies (5, 7, and 17) within monosomal karyotype (MK+)/complex karyotype (CK+) acute myeloid leukemia (AML) was investigated. Most MK+ patients (93%) were found to be MK+/CK+, and 87% had five or more clonal abnormalities (CK ≥5). Median overall survival (OS) for MK+ patients with karyotype complexity ≤4 was 0.4 years compared with OS of 1.0 year for MK− patients with complexity ≤4. The authors report no difference in OS for MK+ vs MK− patients where CK was ≥5. Monosomy 5 did not affect OS, and monosomy 7 had no effect in patients with CK ≥5 or ≤4. Monosomy 17 was present in 43% of patients with CK ≥5, with a markedly worse OS of 0.4 years compared with CK ≥5 patients without monosomy 17.
Data from this study suggest that monosomy 17 may be an independent predictor of worse survival in patients with AML, and the influence of MK+ applies to patients with less complex karyotypes.
