Molecular and prognostic correlates of cytogenetic abnormalities in chronic myelomonocytic leukemia: a Mayo Clinic‐French Consortium Study. Issue 12 (26th September 2014)

• Record Type: Journal Article
• Authors: Wassie, Emnet A.; Itzykson, Raphael; Lasho, Terra L.; Kosmider, Olivier; Finke, Christy M.; Hanson, Curtis A.; Ketterling, Rhett P.; Solary, Eric; Tefferi, Ayalew; Patnaik, Mrinal M.
• Is Part Of: American journal of hematology. Volume 89:Issue 12(2014:Dec.)
• Page Start: 1111
• Page End: 1115
• Publication Date: 2014-09-26
• Subjects: Hematology -- Periodicals; 616.15
• DOI: 10.1002/ajh.23846
• Languages: English
• ISSNs: 0361-8609

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Four hundred and nine patients with chronic myelomonocytic leukemia (CMML) were included in the international collaborative study (268 (66%) and 141 (34%) from Mayo clinic and French consortium respectively). Thirty percent displayed an abnormal karyotype, including; 72% sole, 16% two, and 11% complex abnormalities. The most common abnormalities included; +8 (23%), ‐Y (20%), ‐7/7q‐(14%), 20q‐ (8%), +21 (8%), and der(3q) (8%). Patients with an abnormal karyotype were more likely to be elderly (<italic>P</italic> = 0.03), be anemic (<italic>P</italic> = 0.0009), have leukocytosis (<italic>P</italic> = 0.02) with neutrophilia (<italic>P</italic> = 0.03), demonstrate increased circulating immature myeloid cells (<italic>P</italic> = 0.0003), peripheral blood blasts (<italic>P</italic> < 0.0001), and bone marrow blasts (<italic>P</italic> < 0.0001). <italic>ASXL1</italic> (<italic>P</italic> = 0.04) and <italic>SF3B1</italic> (<italic>P</italic> = 0.03) mutations clustered with an abnormal karyotype, whereas <italic>SRSF2</italic> (<italic>P</italic> = 0.02) mutations occurred more commonly with a normal karyotype. A step‐wise survival analysis resulted in three distinct cytogenetic risk categories: high (complex and monosomal karyotypes), intermediate (all abnormalities not in the high or low risk groups) and low [normal, sole ‐Y and sole der (3q)] with median survivals of 3 [hazard ratio (HR) = 8.1, 95% confidence interval (CI) = 4.6–14.2], 20 (HR = 1.7, 95% CI = 1.2–2.3) and 41 months, respectively. In multivariable analysis, this particular cytogenetic risk stratification remained significant in the context of the Molecular Mayo Model (<italic>P</italic> < 0.0001), MD Anderson prognostic model (<italic>P</italic> < 0.0001), the GFM CMML model (<italic>P</italic> < 0.0001) and was effective in predicting leukemic transformation (<italic>P</italic> = 0.004). Am. J. Hematol. 89:1111–1115, 2014. © 2014 Wiley Periodicals, Inc.</p> </abstract>