Analysis of clinical features of patients with de novo primary acute myeloid leukemia and various chromosomal karyotypes

Abstract

To explore clinical features of patients with de novo primary acute myeloid leukemia (AML) and various chromosomal karyotypes. Clinical data of 144 patients was retrospectively reviewed. The patients included 76 males and 68 females, with a median age of 41.5 years and inter-quartile ranging from 25.25 to 53.75 years. Based on cytogenetic prognostic stratification criteria, the patients were divided into good prognosis (GP group, 55 cases), moderate prognosis (MP group, 71 cases) and poor prognosis (PP group, 18 cases). The PP group was further divided into complex karyotype (CK group, 15 cases) and non-complex karyotype (NCK group, 3 cases), or monosomy karyotype (MK group, 9 cases) and non-monosomy karyotype (NMK group, 9 cases). All data was analyzed by Student's test, Chi-square test or rank sum test based on the type of data. Comparing the clinical data between GP, MP and PP group, there were statistically significant differences in the components of the FAB classification and the mutation of NPM1 and CSF1R genes (χ2=125.444, 15.538 and 7.049, P<0.05). Compared with the NCK group, the CK group had significantly fewer primitive cells in their bone marrow and fewer platelet in their peripheral blood (t=-3.059 and -2.830, P<0.05). Compared with the NMK group, the MK group had significantly fewer red blood cells and lower hemoglobin in their peripheral blood (t=-3.764 and -3.384, P<0.05). For patient with de novo primary AML, those with GP chromosome are more likely to be M2b or M3 with recurrent genetic abnormalities, the MP ones are more likely to be M1, M2a or M5 of AML-NOS based on WHO classification and associate with NPM1 mutations, while the PP ones are more likely to be M2a of AML-NOS based on WHO classification and M5 with recurrent genetic abnormalities and associate with CSF1R mutations. Compared with those with NCK chromosomes, the CK ones have lower proportion of primitive cells in their bone marrow and fewer platelets in peripheral blood. Compared with those with NMK chromosomes, the MK ones have lower red blood cell count and hemoglobin in their peripheral blood.