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Blood Cancer J. 2014 Feb 28;4:e188. doi: 10.1038/bcj.2014.10.

Incidence and prognostic significance of karyotypic subgroups in older patients with acute myeloid leukemia: the Swedish population-based experience.

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1] Department of Hematology and Coagulation, Skåne University Hospital, Lund, Sweden [2] Department of Hematology/Transplantation, Stem Cell Center, Lund University, Lund, Sweden.
Regional Cancer Center in South Sweden, Skåne University Hospital, Lund, Sweden.
1] Department of Clinical Genetics, University and Regional Laboratories Region Skåne, Lund, Sweden [2] Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden.
Department of Hematology, Linköping University Hospital, Linköping, Sweden.
Department of Medicine, Central Hospital Skövde, Skovde, Sweden.
Hematology Center, Karolinska University Hospital, Huddinge and Stockholm, Sweden.
Department of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Department of Medicine, Örebro University Hospital, Örebro, Sweden.
Department of Radiation Sciences, Umeå University, Umeå, Sweden.
Department of Hematology, Academic Hospital, Uppsala, Sweden.


The Swedish population-based acute myeloid leukemia registry contains data from 3251 patients (excluding acute promyelocytic leukemia) diagnosed between 1997 and 2006. Informative cytogenetic data from 1893 patients were retrospectively added, including 1054 patients aged between 60 and 79 years. Clonal abnormalities were found in 57% of the informative karyotypes. Karyotypic patterns differed by age: t(8;21), inv(16) and t(11q23) were more common in younger patients, whereas loss of 5q, 7q and 17p, monosomal karyotype (MK) and complex karyotypes were more common in older patients. Loss of 5q, 7q and 17p often occurred together within MK. Patients with 5 chromosome abnormalities had worse overall survival than those with fewer abnormalities or normal karyotype in all age groups. Loss of 5q, 7q and/or 17p had, in contrast to MK, a further negative impact on survival. Multivariable Cox regression analyses on risk factors in patients <80 years with cytogenetic abnormalities and intensive treatment revealed that age and performance status had the most significant impact on survival (both P<0.001), followed by sex (P=0.0135) and a karyotype including -7/del(7q) (P=0.048).

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