Abstract：Objective To study the relationship between loss of sex chromosomes and prognosis in children with acute myeloid leukemia (AML) M2 subtype. Methods According to cytogenetic characteristics, 106 children with AML were divided into three groups: patients with normal karyotype (Group A, n=26), patients with abnormal karyotype who had no loss of sex chromosomes (Group B, n=52), and patients with abnormal karyotype who had loss of sex chromosomes (Group C, n=28). Prognosis was compared between the three groups. Results The 5-year event-free survival (EFS) rates of Groups A, B, and C were (38.9±11.2)%, (59.3±7.3)%, and (66.5±10.5)%, respectively; the EFS of Group C was significantly higher than that of Group A (P=0.035). The 5-year overall survival (OS) rates of Groups A, B, and C were (54.3±13.5)%, (68.1±7.7)%, and (77.9±9.8)%, respectively (P>0.05). The 5-year EFS of 58 patients with t(8;21) was (63.3±7.3)%, significantly higher than that of patients with normal karyotype (P=0.015). All the 28 cases in Group C had t(8;21), and their 5-year EFS was not significantly different from that of patients with t(8;21) in Group B (P>0.05). Conclusions Loss of sex chromosomes is a favorable karyotype in children with AML M2 subtype and the patients in this group mostly have t(8;21). Why loss of sex chromosomes indicates a favorable prognosis is probably because it is accompanied by t(8;21) in the patients.
JIA Yue-Ping,ZUO Ying-Xi,LU Ai-Dong et al. Prognostic impact of loss of sex chromosomes in children with acute myeloid leukemia subtype M2[J]. CJCP, 2015, 17(2): 168-171.
Rubnitz JE, Inaba H. Childhood acute myeloid leukaemia[J]. Br J Haematol, 2012, 159(3): 259-276.
[2]
Braoudaki M, Tzortzatou-Stathopoulou F. Clinical cytogenetics in pediatric acute leukemia: an update[J]. Clin Lymphoma Myeloma Leuk, 2012, 12(4): 230-237.
Mrozek K, Marcucci G, Nicolet D, et al. Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia[J]. J Clin Oncol, 2012, 30(36): 4515-4523.
[6]
Kumari P, LinqappaKacitha B, Obula Reddy C, et al. A rare cytogenetic presentation of acute myeloid leukemia(AML-M2)[J]. Acta Med Iran, 2012, 50(12): 827-830.
Estey EH. Acute myeloid leukemia: 2013 update on risk-stratification and management[J]. Am J Hematol, 2013, 88(4): 318-327.
[10]
Appelbaum FR, Kopecky KJ, Tallman MS, et al. The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations[J]. Br J Haematol, 2006, 135(2): 165-173.
[11]
Lin P, Chen L, Luthra R, et al. Acute myeloid leukemia harboring t(8;21)(q22;q22): a heterogeneous disease with poor outcome in a subset of patients unrelated to secondary cytogenetic aberrations[J]. Mod Pathol, 2008, 21(8): 1029-1036.
[12]
Hann IM, Webb DK, Gibson BE, et al. MRC trials in childhood acute myeloid leukaemia[J]. Ann Hematol, 2004, 83(Suppl 1): S108-S112.
[13]
Rege K, Swansbury GJ, Atra AA, et al. Disease features in acute myeloid leukemia with t(8;21)(q22;q22). Influence of age, secondary karyotype abnormalities, CD19 status, and extramedullary leukemia on survival[J]. Leuk Lymphoma, 2000, 40(1-2): 67-77.
[14]
Grimwade D, Hills RK, Moorman AV, et al. Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials[J]. Blood, 2010, 116(3): 354-365.
