Abstract
BackgroundAcute myeloid leukemia (AML) is rare in children. Although complex karyotype (CK) defined as ≥ 3 cytogenetic abnormalities is an adverse risk factor in adult AML, its prognostic impact on childhood AML remains to be determined.ResultsWe studied the prevalence, cytogenetic and mutational features, and outcome impact of CK in a cohort of 284 Chinese children with de novo AML. Thirty-four (12.0%) children met the criteria for CK-AML with atypical CK being more frequent than typical CK featured with -5/5q-, -7/7q-, and/or 17p aberration. Mutational prevalence was low and co-occurrence mutants were uncommon. Children with CK-AML showed shorter overall survival (OS) (5-year OS: 26.7 ± 10.6% vs. 37.5 ± 8.6%, p = 0.053) and event-free survival (EFS) (5-year EFS: 26.7 ± 10.6% vs. 38.8 ± 8.6%, p = 0.039) compared with those with intermediate-risk genetics. Typical CK tended to correlate with a decreased OS than atypical CK (5-year OS: 0 vs. 33 ± 12.7%.; p = 0.084), and CK with ≥ 5 cytogenetic aberrations was associated with an inferior survival compared with CK with ≤ 4 aberrations (5-year OS: 13.6 ± 11.7% vs. 50.0 ± 18.6%; p = 0.040; 5-year EFS: 13.6 ± 11.7% vs. 50.0 ± 18.6%; p = 0.048).ConclusionOur results demonstrate CK as an adverse risk factor for reduced survival in childhood AML. Our findings shed light on the cytogenetic and mutational profile of childhood CK-AML and would inform refinement of risk stratification in childhood AML to improve outcomes.
Highlights
Acute myeloid leukemia (AML) is rare in children
Our study showed complex karyotype (CK) was associated with decreased survival in childhood AML and its impact on outcome correlated with the number of chromosomal aberrations
Our results demonstrate for the first time that among Chinese children with CK-AML, atypical CK was more frequent than typical CK, mutational incidences were low and concomitant mutants were uncommon
Summary
Acute myeloid leukemia (AML) is rare in children. Complex karyotype (CK) defined as ≥ 3 cytogenetic abnormalities is an adverse risk factor in adult AML, its prognostic impact on childhood AML remains to be determined. Complex karyotype (CK), commonly defined as three or more chromosomal aberrations in the absence of the WHO recurrent genetic aberrations of t(8;21)(q22;q22), inv(16) (p13.1q22) /t(16;16) (p13.1;q22); t(15;17)(q22;q12); t(9;11)(p22;q23), t(6;9)(p23;q34), inv(3)(q21q26)/t(3;3) (q21;q26), and t(9;22)(q34;q11.2) [5,6,7,8], is considered as an adverse risk factor in adult AML, but its prognostic impact on childhood AML remains to be determined [5, 9]. Differences in AML genetic profile between adults and children are well documented [10,11,12], and their impact on outcome may differ among age groups [6, 13]. Few studies have been focused on the cytogenetic and molecular profile of childhood CKAML, largely owing to the rarity of AML in children and none in a Chinese population [18,19,20]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
