Cytogenetic risk stratification in chronic myelomonocytic leukemia
Open Access
- 25 November 2010
- journal article
- Published by Ferrata Storti Foundation (Haematologica) in Haematologica
- Vol. 96 (3), 375-383
- https://doi.org/10.3324/haematol.2010.030957
Abstract
The prognostic value of cytogenetic findings in chronic myelomonocytic leukemia is unclear. Our purpose was to evaluate the independent prognostic impact of cytogenetic abnormalities in a large series of patients with chronic myelomonocytic leukemia included in the database of the Spanish Registry of Myelodysplastic Syndromes. We studied 414 patients with chronic myelomonocytic leukemia according to WHO criteria and with a successful conventional cytogenetic analysis at diagnosis. Different patient and disease characteristics were examined by univariate and multivariate methods to establish their relationship with overall survival and evolution to acute myeloid leukemia. Patients with abnormal karyotype (110 patients, 27%) had poorer overall survival (P=0.001) and higher risk of acute myeloid leukemia evolution (P=0.010). Based on outcome analysis, three cytogenetic risk categories were identified: low risk (normal karyotype or loss of Y chromosome as a single anomaly), high risk (presence of trisomy 8 or abnormalities of chromosome 7, or complex karyotype), and intermediate risk (all other abnormalities). Overall survival at five years for patients in the low, intermediate, and high risk cytogenetic categories was 35%, 26%, and 4%, respectively (P<0.001). Multivariate analysis confirmed that this new CMML-specific cytogenetic risk stratification was an independent prognostic variable for overall survival (P=0.001). Additionally, patients belonging to the high-risk cytogenetic category also had a higher risk of acute myeloid leukemia evolution on univariate (P=0.001) but not multivariate analysis. Cytogenetic findings have a strong prognostic impact in patients with chronic myelomonocytic leukemia.Keywords
This publication has 18 references indexed in Scilit:
- Identification of novel cytogenetic markers with prognostic significance in a series of 968 patients with primary myelodysplastic syndromes.2005
- Two groups of chronic myelomonocytic leukaemia: myelodysplastic and myeloproliferative. Prognostic implications in a series of a single centerLeukemia Research, 2002
- Prognostic factors and scoring systems in chronic myelomonocytic leukemia: a retrospective analysis of 213 patientsBlood, 2002
- The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties.1998
- International Scoring System for Evaluating Prognosis in Myelodysplastic SyndromesBlood, 1997
- Prognosis of chronic myelomonocytic leukemia.1996
- The chronic myeloid leukaemias: guidelines for distinguishing chronic granulocytic, atypical chronic myeloid, and chronic myelomonocytic leukaemia: Proposals by the French ‐ American ‐ British Cooperative Leukaemia GroupBritish Journal of Haematology, 1994
- Chronic myelomonocytic leukemia: Single entity or heterogeneous disorder?: A prospective multicenter study of 100 patientsCancer Genetics and Cytogenetics, 1991
- Prognostic factors in adult chronic myelomonocytic leukemia: an analysis of 107 cases.Journal of Clinical Oncology, 1988
- Proposals for the classification of the myelodysplastic syndromes.1982