Complex Karyotype in Pediatric Acute Myeloid Leukemia

MYELOID TUMORS , ,

EV Fleishman1, OI Sokova1, AV Popa1, II Kalinina2, LN Konstantinova1

1 N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

2 Dmitrii Rogachev Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology under the Ministry of Health of the Russian Federation, 1 Samory Mashela str., Moscow, Russian Federation, 117997

For correspondence: Elena Vol’fovna Fleischman, DSci, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)323-57-22; e-mail: flesok@yandex.ru

For citation: Fleishman EV, Sokova OI, Popa AV, et al. Complex Karyotype in Pediatric Acute Myeloid Leukemia. Clinical oncohematology. 2015;8(2):151–60 (In Russ).

ABSTRACT

Objective. To evaluate the clinical relevance of the complex karyotype in pediatric practice.

Methods. In this study, we investigated the karyotype of 521 patients with de novo AML (299 children and 222 adults). Among them 34 pediatric patients and 25 adults had various complex karyotypes.

Results. Certain differences of complex karyotypes between pediatric and adult AML were revealed. Some peculiarities of marker sets were also found: in children, such high-risk markers as monosomy 5 and del(5q) as well as monosomy 7 and del(7q) were less frequent than in adults. Monosomal complex karyotypes were less common in children. Specific distribution of blast cell morphological types was observed in pediatric AML with complex karyotypes. Unlike AML with noncomplex karyotype, where the M2 type was found in almost a half (47.9 %) of patients, in patients with 3 and more chromosome aberrations its incidence was 11.8 % only (p = 0,000). However, incidence of M5 and rare M0 and M7 types in patients with complex karyotype was higher than in the others. RFS in patients with a complex karyotype was similar to that of remaining patients in the high-risk group: 38.4 ± 9.9 % and 30.6 ± 8.8 %, respectively. The OS rate of patients with a complex karyotype was practically identical to that of intermediate-risk group patients: 48.0 ± 10.0 % and 48.0 ± 10.0 %, respectively. There was a comparatively high 10-year survival rate (RFS and OS were higher than 30 %) in the pediatric high-risk group. Ten of 25 (40 %) patients with complex karyotype survived five years and 7 of them persisted in complete remission for more than 10 years. Five-year survival in adults from high-risk group is up to 15 %.

Conclusion. Analysis of data on survival of pediatric AML does not answer a question in which prognostic group (high or intermediate-risk) cases of AML with complex karyotypes without high-risk chromosome markers must be included.

Keywords: pediatric acute myeloid leukemia, chromosome aberrations, complex karyotype.

Received: November 26, 2014

Accepted: February 2, 2015

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