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Rebecca Olin, MD, MS


Marker Chromosome: Poor Prognostic Factor in AML After Allogeneic HSCT?

By: Hillary Ojeda
Posted: Tuesday, November 24, 2020

For patients with acute myeloid leukemia (AML), marker chromosome—a fragmented chromosome that originates from marked genomic instability—appears to be an independent risk factor of poorer overall survival after allogeneic hematopoietic stem cell transplantation (HSCT), according to a study published in the European Journal of Haematology. Masayoshi Masuko, MD, PhD, of the Niigata University Medical and Dental Hospital, Japan, and colleagues are planning further studies with larger samples sizes to better understand the impact of marker chromosome, which is identified in approximately 10% of AML cases.

“Marker chromosome was a risk factor for leukemia relapse and overall survival even after allogeneic HSCT in our study,” the authors found. “Marker chromosome may reflect marked genomic instability and lead to a poor prognosis.”

For this study, the data for 162 patients with AML were reviewed after allogeneic HSCT. The patients had undergone treatment at one of two hospitals between 1990 and 2017. The median follow-up was 2 years. Analysis of chromosome G-banding was conducted at diagnosis.

A total of 96 patients had chromosome abnormalities, whereas 66 patients had a standard karyotype. Marker chromosome was detected in 14 patients, or 8.6% of the total 162 patients. Of that group, 11 had adverse-risk karyotypes. Overall survival for the patients with marker chromosome was 26.8%, compared with 62.2% for those without it. The 2-year cumulative incidence rates of relapse were 80.4% in those with marker chromosome and 35.5% in patients without it. Adverse-risk patients with marker chromosome had worse 2-year overall survival and a higher 2-year cumulative incidence of relapse.

The investigators concluded: “To confirm whether marker chromosome is applicable as a new risk factor in chromosome risk classification, such as the refined Medical Research Council or European LeukemiaNet, further analysis with a larger sample size is needed.”

Disclosure: The study authors reported no conflicts of interest.

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