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Blood Cancer J. 2016 Jan 15;6:e386. doi: 10.1038/bcj.2015.114.

Karyotype complexity and prognosis in acute myeloid leukemia.

Author information

  • 1Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
  • 2Abteilung Innere Medizin V, Universität Heidelberg, Heidelberg, Germany.
  • 3Medizinische Klinik A, Universitätsklinikum Münster, Münster, Germany.
  • 4Robert Bosch Hospital, Stuttgart, Germany.
  • 5Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • 6Asklepios Klinik St Georg, Hamburg, Germany.
  • 7Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany.
  • 8Medizinische Klinik 5, Universitätsklinikum Erlangen, Erlangen, Germany.
  • 9Medizinische Klinik II, Klinikum der J.W. Goethe Universität, Frankfurt, Germany.
  • 10Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Germany.
  • 11Kliniken für Innere Medizin, Hämatologie/Onkologie und Immunologie, Universitätsklinikum Marburg, Marburg, Germany.
  • 12University Hospital Brno, Brno, Czech Republic.
  • 13Klinik für Hämatologie und Onkologie, Rems-Murr-Kliniken, Winnenden, Germany.


A complex aberrant karyotype consisting of multiple unrelated cytogenetic abnormalities is associated with poor prognosis in patients with acute myeloid leukemia (AML). The European Leukemia Net classification and the UK Medical Research Council recommendation provide prognostic categories that differ in the definition of unbalanced aberrations as well as the number of single aberrations. The aim of this study on 3526 AML patients was to redefine and validate a cutoff for karyotype complexity in AML with regard to adverse prognosis. Our study demonstrated that (1) patients with a pure hyperdiploid karyotype have an adverse risk irrespective of the number of chromosomal gains, (2) patients with translocation t(9;11)(p21∼22;q23) have an intermediate risk independent of the number of additional aberrations, (3) patients with ⩾4 abnormalities have an adverse risk per se and (4) patients with three aberrations in the absence of abnormalities of strong influence (hyperdiploid karyotype, t(9;11)(p21∼22;q23), CBF-AML, unique adverse-risk aberrations) have borderline intermediate/adverse risk with a reduced overall survival compared with patients with a normal karyotype.

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