文章：

单体核型急性髓系白血病患者中，单一单体核型作为相对较好的生存因素

Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype

原文发布日期：2015-10-16

DOI: 10.1038/bcj.2015.84

类型: Original Article

开放获取: 是

英文摘要：

Monosomal karyotype (MK) defined by either ⩾2 autosomal monosomies or single monosomy with at least one additional structural chromosomal abnormality is associated with a dismal prognosis in patients with acute myeloid leukemia (AML). It was detected in 174 of 3041 AML patients in South Korean Registry. A total of 119 patients who had received induction therapy were finally analyzed to evaluate the predictive factors for a positive prognosis. On multivariate analysis, single monosomy, the absence of abn(17p), ⩾10% of cells with normal metaphase and the achievement of a complete remission (CR) after induction therapy were significant factors for more favorable outcomes. Especially, single monosomy remained as a significantly independent prognostic factor for superior survival in both patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR and who did not. Allo-HSCT in CR improved overall survival significantly only in patients with a single monosomy. Our results suggest that MK-AML may be biologically different according to the karyotypic subtype and that allo-HSCT in CR should be strongly recommended to patients with a single monosomy. For other patients, more prudent treatment strategies should be examined. Furthermore, the biological mechanism by which a single monosomy influences survival should be investigated.

摘要翻译： 

单体型核型（MK）的定义是存在≥2个常染色体单体或单个单体伴至少一个额外结构染色体异常，与急性髓系白血病（AML）患者的不良预后相关。韩国登记库中3041例AML患者中检测到174例存在该核型。最终对接受诱导治疗的119例患者进行分析，以评估阳性预后的预测因素。多变量分析显示，单个单体、无abn(17p)、正常中期细胞比例≥10%以及诱导治疗后达到完全缓解（CR）是更良好结局的重要影响因素。特别是，单个单体在CR期接受异基因造血干细胞移植（allo-HSCT）与未移植的患者中，均是显著独立预示更优生存的预后因素。仅在单个单体患者中，CR期进行allo-HSCT可显著改善总生存期。我们的研究结果表明，MK-AML可能因核型亚型不同而存在生物学差异，对于单个单体患者应强烈推荐在CR期进行allo-HSCT。对于其他患者，则需要探讨更谨慎的治疗策略。此外，应深入研究单个单体影响生存的生物学机制。

原文链接：

Single monosomy as a relatively better survival factor in acute myeloid leukemia patients with monosomal karyotype