Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2): A Bone Marrow Pathology Group study

Heesun J. Rogers, James W. Vardiman, John Anastasi, Gordana Raca, Natasha Marie Savage, Athena M. Cherry, Daniel Arber, Erika Moore, Jennifer J.D. Morrissette, Adam Bagg, Yen Chun Liu, Susan Mathew, Attilio Orazi, Pei Lin, Sa A. Wang, Carlos E. Bueso-Ramos, Kathryn Foucar, Robert P. Hasserjian, Ramon V. Tiu, Matthew KarafaEric D. Hsi

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Abstract

Acute myeloid leukemia and myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) have a poor prognosis. Indeed, the inv(3)(q21q26.2)/t(3;3)(q21;q26.2) has been recognized as a poor risk karyotype in the revised International Prognostic Scoring System. However, inv(3)(q21q26.2)/t(3;3)(q21;q26.2) is not among the cytogenetic abnormalities pathognomonic for diagnosis of acute myeloid leukemia irrespective of blast percentage in the 2008 WHO classification. This multicenter study evaluated the clinico-pathological features of acute myeloid leukemia/myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) and applied the revised International Prognostic Scoring System to myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2). A total of 103 inv(3)(q21q26.2)/t(3;3)(q21;q26.2) patients were reviewed and had a median bone marrow blast count of 4% in myelodysplastic syndrome (n=40) and 52% in acute myeloid leukemia (n=63) (P<0.001). Ninety-one percent of patients showed characteristic dysmegakaryopoiesis. There was no difference in overall survival between acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) (12.9 vs. 7.9 months; P=0.16). Eighty-three percent of patients died (median follow up 7.9 months). Complex karyotype, monosomal karyotype and dysgranulopoiesis (but not blast percentage) were independent poor prognostic factors in the entire cohort on multivariable analysis. The revised International Prognostic Scoring System better reflected overall survival of inv(3)(q21q26.2)/t(3;3)(q21;q26.2) than the International Prognostic Scoring System but did not fully reflect the generally dismal prognosis. Our data support consideration of myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) as an acute myeloid leukemia with recurrent genetic abnormalities, irrespective of blast percentage.

Original languageEnglish (US)
Pages (from-to)821-829
Number of pages9
JournalHaematologica
Volume99
Issue number5
DOIs
StatePublished - May 1 2014

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Myelodysplastic Syndromes
Karyotype
Acute Myeloid Leukemia
Bone Marrow
Pathology
Survival
Chromosome Aberrations
Multicenter Studies

ASJC Scopus subject areas

  • Hematology

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Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) : A Bone Marrow Pathology Group study. / Rogers, Heesun J.; Vardiman, James W.; Anastasi, John; Raca, Gordana; Savage, Natasha Marie; Cherry, Athena M.; Arber, Daniel; Moore, Erika; Morrissette, Jennifer J.D.; Bagg, Adam; Liu, Yen Chun; Mathew, Susan; Orazi, Attilio; Lin, Pei; Wang, Sa A.; Bueso-Ramos, Carlos E.; Foucar, Kathryn; Hasserjian, Robert P.; Tiu, Ramon V.; Karafa, Matthew; Hsi, Eric D.

In: Haematologica, Vol. 99, No. 5, 01.05.2014, p. 821-829.

Research output: Contribution to journalArticle

Rogers, HJ, Vardiman, JW, Anastasi, J, Raca, G, Savage, NM, Cherry, AM, Arber, D, Moore, E, Morrissette, JJD, Bagg, A, Liu, YC, Mathew, S, Orazi, A, Lin, P, Wang, SA, Bueso-Ramos, CE, Foucar, K, Hasserjian, RP, Tiu, RV, Karafa, M & Hsi, ED 2014, 'Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2): A Bone Marrow Pathology Group study', Haematologica, vol. 99, no. 5, pp. 821-829. https://doi.org/10.3324/haematol.2013.096420
Rogers, Heesun J. ; Vardiman, James W. ; Anastasi, John ; Raca, Gordana ; Savage, Natasha Marie ; Cherry, Athena M. ; Arber, Daniel ; Moore, Erika ; Morrissette, Jennifer J.D. ; Bagg, Adam ; Liu, Yen Chun ; Mathew, Susan ; Orazi, Attilio ; Lin, Pei ; Wang, Sa A. ; Bueso-Ramos, Carlos E. ; Foucar, Kathryn ; Hasserjian, Robert P. ; Tiu, Ramon V. ; Karafa, Matthew ; Hsi, Eric D. / Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) : A Bone Marrow Pathology Group study. In: Haematologica. 2014 ; Vol. 99, No. 5. pp. 821-829.
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abstract = "Acute myeloid leukemia and myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) have a poor prognosis. Indeed, the inv(3)(q21q26.2)/t(3;3)(q21;q26.2) has been recognized as a poor risk karyotype in the revised International Prognostic Scoring System. However, inv(3)(q21q26.2)/t(3;3)(q21;q26.2) is not among the cytogenetic abnormalities pathognomonic for diagnosis of acute myeloid leukemia irrespective of blast percentage in the 2008 WHO classification. This multicenter study evaluated the clinico-pathological features of acute myeloid leukemia/myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) and applied the revised International Prognostic Scoring System to myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2). A total of 103 inv(3)(q21q26.2)/t(3;3)(q21;q26.2) patients were reviewed and had a median bone marrow blast count of 4{\%} in myelodysplastic syndrome (n=40) and 52{\%} in acute myeloid leukemia (n=63) (P<0.001). Ninety-one percent of patients showed characteristic dysmegakaryopoiesis. There was no difference in overall survival between acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) (12.9 vs. 7.9 months; P=0.16). Eighty-three percent of patients died (median follow up 7.9 months). Complex karyotype, monosomal karyotype and dysgranulopoiesis (but not blast percentage) were independent poor prognostic factors in the entire cohort on multivariable analysis. The revised International Prognostic Scoring System better reflected overall survival of inv(3)(q21q26.2)/t(3;3)(q21;q26.2) than the International Prognostic Scoring System but did not fully reflect the generally dismal prognosis. Our data support consideration of myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) as an acute myeloid leukemia with recurrent genetic abnormalities, irrespective of blast percentage.",
author = "Rogers, {Heesun J.} and Vardiman, {James W.} and John Anastasi and Gordana Raca and Savage, {Natasha Marie} and Cherry, {Athena M.} and Daniel Arber and Erika Moore and Morrissette, {Jennifer J.D.} and Adam Bagg and Liu, {Yen Chun} and Susan Mathew and Attilio Orazi and Pei Lin and Wang, {Sa A.} and Bueso-Ramos, {Carlos E.} and Kathryn Foucar and Hasserjian, {Robert P.} and Tiu, {Ramon V.} and Matthew Karafa and Hsi, {Eric D.}",
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TY - JOUR

T1 - Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2)

T2 - A Bone Marrow Pathology Group study

AU - Rogers, Heesun J.

AU - Vardiman, James W.

AU - Anastasi, John

AU - Raca, Gordana

AU - Savage, Natasha Marie

AU - Cherry, Athena M.

AU - Arber, Daniel

AU - Moore, Erika

AU - Morrissette, Jennifer J.D.

AU - Bagg, Adam

AU - Liu, Yen Chun

AU - Mathew, Susan

AU - Orazi, Attilio

AU - Lin, Pei

AU - Wang, Sa A.

AU - Bueso-Ramos, Carlos E.

AU - Foucar, Kathryn

AU - Hasserjian, Robert P.

AU - Tiu, Ramon V.

AU - Karafa, Matthew

AU - Hsi, Eric D.

PY - 2014/5/1

Y1 - 2014/5/1

N2 - Acute myeloid leukemia and myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) have a poor prognosis. Indeed, the inv(3)(q21q26.2)/t(3;3)(q21;q26.2) has been recognized as a poor risk karyotype in the revised International Prognostic Scoring System. However, inv(3)(q21q26.2)/t(3;3)(q21;q26.2) is not among the cytogenetic abnormalities pathognomonic for diagnosis of acute myeloid leukemia irrespective of blast percentage in the 2008 WHO classification. This multicenter study evaluated the clinico-pathological features of acute myeloid leukemia/myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) and applied the revised International Prognostic Scoring System to myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2). A total of 103 inv(3)(q21q26.2)/t(3;3)(q21;q26.2) patients were reviewed and had a median bone marrow blast count of 4% in myelodysplastic syndrome (n=40) and 52% in acute myeloid leukemia (n=63) (P<0.001). Ninety-one percent of patients showed characteristic dysmegakaryopoiesis. There was no difference in overall survival between acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) (12.9 vs. 7.9 months; P=0.16). Eighty-three percent of patients died (median follow up 7.9 months). Complex karyotype, monosomal karyotype and dysgranulopoiesis (but not blast percentage) were independent poor prognostic factors in the entire cohort on multivariable analysis. The revised International Prognostic Scoring System better reflected overall survival of inv(3)(q21q26.2)/t(3;3)(q21;q26.2) than the International Prognostic Scoring System but did not fully reflect the generally dismal prognosis. Our data support consideration of myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) as an acute myeloid leukemia with recurrent genetic abnormalities, irrespective of blast percentage.

AB - Acute myeloid leukemia and myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) have a poor prognosis. Indeed, the inv(3)(q21q26.2)/t(3;3)(q21;q26.2) has been recognized as a poor risk karyotype in the revised International Prognostic Scoring System. However, inv(3)(q21q26.2)/t(3;3)(q21;q26.2) is not among the cytogenetic abnormalities pathognomonic for diagnosis of acute myeloid leukemia irrespective of blast percentage in the 2008 WHO classification. This multicenter study evaluated the clinico-pathological features of acute myeloid leukemia/myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) and applied the revised International Prognostic Scoring System to myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2). A total of 103 inv(3)(q21q26.2)/t(3;3)(q21;q26.2) patients were reviewed and had a median bone marrow blast count of 4% in myelodysplastic syndrome (n=40) and 52% in acute myeloid leukemia (n=63) (P<0.001). Ninety-one percent of patients showed characteristic dysmegakaryopoiesis. There was no difference in overall survival between acute myeloid leukemia and myelodysplastic syndrome patients with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) (12.9 vs. 7.9 months; P=0.16). Eighty-three percent of patients died (median follow up 7.9 months). Complex karyotype, monosomal karyotype and dysgranulopoiesis (but not blast percentage) were independent poor prognostic factors in the entire cohort on multivariable analysis. The revised International Prognostic Scoring System better reflected overall survival of inv(3)(q21q26.2)/t(3;3)(q21;q26.2) than the International Prognostic Scoring System but did not fully reflect the generally dismal prognosis. Our data support consideration of myelodysplastic syndrome with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) as an acute myeloid leukemia with recurrent genetic abnormalities, irrespective of blast percentage.

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