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Normal karyotype mosaicism in adult AML patients with adverse-risk and undefined karyotype: preliminary report of treatment outcomes after hematopoietic stem cell transplantation

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Abstract

Karyotype analysis in acute myeloid leukemia (AML) is one of the powerful prognostic factors for complete remission (CR), relapse, and overall survival (OS). Cytogenetic mosaicism is considered to be one of the important characteristics in expression of phenotypic manifestations. However, it has not come into focus due to emerging molecular biological approaches and the results of a number of mutation studies. Clinical correlates and prognostic relevance of mosaicism were evaluated in 163 AML patients [adverse-risk karyotypes (n = 72) and undefined karyotypes (n = 91)]. All patients were treated by induction and consolidation chemotherapies and finally went on hematopoietic stem cell transplantations (HSCT). Patients were divided into two subgroups, either with or without normal karyotype (NK) mosaicism. Seventy patients exhibited NK mosaicism and 93 did not. There were no significant differences in age, gender, chemotherapy cycles to achieve CR, HSCT donor type, source or intensity properties between the two subgroups. We found that NK mosaicism remaining in adverse-risk and undefined karyotype at diagnosis significantly correlates with better OS (p = 0.001) and lower CIR (p = 0.021) rate after HSCT. Our data show that the poor prognostic properties of unfavorable risk karyotype can be overcome to a great extent by allogeneic HSCT and chronic GVHD, especially in the subgroup with NK mosaicism. Cytogenetic mosaicism at initial diagnosis can be an influential factor for survival outcomes, even after HSCT.

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Acknowledgments

This study was supported by a Grant from the National R&D Program for Cancer Control, Ministry for Health and Welfare, Republic of Korea (1020370).

Conflict of interest

Authors declare no conflict of interest in this study.

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Authors and Affiliations

  1. Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-070, Korea

    Jae-Ho Yoon, Hee-Je Kim, Seung-Hwan Shin, Seung-Ah Yahng, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Chang-Ki Min, Seok-Goo Cho, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min & Chong-Won Park

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  1. Jae-Ho Yoon
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  2. Hee-Je Kim
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  3. Seung-Hwan Shin
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  4. Seung-Ah Yahng
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  5. Byung-Sik Cho
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  6. Ki-Seong Eom
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  7. Yoo-Jin Kim
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  13. Woo-Sung Min
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  14. Chong-Won Park
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Correspondence to Hee-Je Kim.

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Yoon, JH., Kim, HJ., Shin, SH. et al. Normal karyotype mosaicism in adult AML patients with adverse-risk and undefined karyotype: preliminary report of treatment outcomes after hematopoietic stem cell transplantation. Int J Hematol 97, 773–781 (2013). https://doi.org/10.1007/s12185-013-1335-7

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  • DOI: https://doi.org/10.1007/s12185-013-1335-7

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