Open Access

Cytogenetic characteristics of and prognosis for acute myeloid leukemia in 107 children

Wanzi Chen
Wanzi Chen
, 
Jinghui Yang
Jinghui Yang
 and 
Ping Chen
Ping Chen
   | Apr 30, 2021
Asian Biomedicine's Cover Image
About this article
Previous Article
Next Article
Cite
Article Category: Original article
Published Online: Apr 30, 2021
Page range: 79 - 89
DOI: https://doi.org/10.2478/abm-2021-0010
Keywords
© 2021 Wanzi Chen et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

FAB cooperative group subtype classification of the 107 cases of AML in childhood. AML, acute myeloid leukemia; FAB, French-American-British.
FAB cooperative group subtype classification of the 107 cases of AML in childhood. AML, acute myeloid leukemia; FAB, French-American-British.

Figure 2

FISH results. A. RUNX1-RUNX1T1 fusion, 2Y1R1G, ×1000, B. MLL breakage, 1Y1R1G, ×1000. When gene fusion occurred, two yellow fusion signals are produced by the proximity or superposition of green and red chromosomes, one red and one green (2Y1R1G) signal are presented. If not, two red and two green signals were presented (2R2G). When gene breakage occurred, one yellow chromosome breaks apart as one red and one green (1R1G) signal, and one yellow signal is presented (1Y1R1G). If not, two yellow signals are presented (2Y). Scale bars indicate 10 μm. FISH, fluorescence in situ hybridization.
FISH results. A. RUNX1-RUNX1T1 fusion, 2Y1R1G, ×1000, B. MLL breakage, 1Y1R1G, ×1000. When gene fusion occurred, two yellow fusion signals are produced by the proximity or superposition of green and red chromosomes, one red and one green (2Y1R1G) signal are presented. If not, two red and two green signals were presented (2R2G). When gene breakage occurred, one yellow chromosome breaks apart as one red and one green (1R1G) signal, and one yellow signal is presented (1Y1R1G). If not, two yellow signals are presented (2Y). Scale bars indicate 10 μm. FISH, fluorescence in situ hybridization.

Figure 3

The OS curves are shown for the 4 groups of childhood AML. Group A, AML with t(15;17)/PML-RARA; Group B, AML with t(8;21)/RUNX1-RUNX1T1 or inv(16) and t(16;16)/CBFB-MYH11; Group C, AML with -7 or complex karyotypes; Group D, AML with normal or other cytogenetic changes. AML, acute myeloid leukemia; OS, overall survival.
The OS curves are shown for the 4 groups of childhood AML. Group A, AML with t(15;17)/PML-RARA; Group B, AML with t(8;21)/RUNX1-RUNX1T1 or inv(16) and t(16;16)/CBFB-MYH11; Group C, AML with -7 or complex karyotypes; Group D, AML with normal or other cytogenetic changes. AML, acute myeloid leukemia; OS, overall survival.

Figure 4

The EFS curves are shown for the 4 groups of childhood AML. Group A, AML with t(15;17)/PML-RARA; Group B, AML with t(8;21)/RUNX1-RUNX1T1 or inv(16) and t(16;16)/CBFB-MYH11; Group C, AML with −7 or complex karyotypes; Group D, AML with normal or other cytogenetic changes. AML, acute myeloid leukemia; EFS, event-free survival.
The EFS curves are shown for the 4 groups of childhood AML. Group A, AML with t(15;17)/PML-RARA; Group B, AML with t(8;21)/RUNX1-RUNX1T1 or inv(16) and t(16;16)/CBFB-MYH11; Group C, AML with −7 or complex karyotypes; Group D, AML with normal or other cytogenetic changes. AML, acute myeloid leukemia; EFS, event-free survival.

Figure 5

Comparison of overall survival in FAB-M5/M2 with t(8;21)/RUNX1-RUNX1T1. FAB, French-American-British. AQ1
Comparison of overall survival in FAB-M5/M2 with t(8;21)/RUNX1-RUNX1T1. FAB, French-American-British. AQ1

Univariate and multivariate Cox regression analyses for overall survival

Univariate analysis Multivariate analysis
HR (95% CI) P HR (95% CI) P
Karyotype
  A 1.0 1.0
  B 6.52 (0.84–50.60) 0.07 7.27 (0.91–58.11) 0.06
  C 20.26 (2.57–159.75) 0.004* 22.65 (2.73–187.84) 0.004*
  D 7.44 (0.91–61.16) 0.06 5.72 (0.65–50.78) 0.12
Sex
  Male 1.0 1.0
  Female 0.88 (0.43–1.81) 0.73 0.26 (0.31–1.39) 0.26
Age (month)
  <12 1.0 1.0
  ≥12 0.22 (0.05–0.93) 0.25 0.11 (0.02–0.60) 0.19
WBC (×109/L)
  <100 1.0 1.0
  ≥100 1.87 (0.65–5.32) 0.04* 2.06 (0.69–6.08) 0.011*
Morphological CR in first course
  Not CR 1.0 1.0
  CR 0.89 (0.26–1.12) 0.10 0.69 (0.32–1.46) 0.33
Marrow transplantation
  Yes 1.0 1.0
  No 1.70 (0.41–7.13) 0.47 2.44 (0.56–10.63) 0.24

Relationship between cytogenetic abnormalities and FAB subtypes.

Cytogenetic abnormalities FAB subtype (case) Detection of fusion gene
FISH RT-qPCR
t(15;17) APL (13) + (all)† + (all)†
t(8;21) M2 (3), M5 (5) + (all) + (all)
t(8;21), −X/Y M2 (7), M5 (3) + (all) + (all)
inv(16)/t(16;16) M4 (2) + (all)‡ + (all)‡
Complex karyotypes M0 (2), M1 (2), M2 (7), M5 (11), M6 (2), M7 (1) − (all) − (all)
−7 M0 (1) − (all) − (all)
Normal karyotypes M0 (2), M2 (2), M5 (10), M6 (1) + (3)§ + (3)§
Others M0 (3), M5 (4) − (all) − (all)
No split phase M0 (1), M1 (4), M2 (7), M5 (14) + (8)§ + (8)§

Clinical characteristics of 92 patients with AML cytogenetic abnormality

Group Case Male/female P Median age in months (range) P WBC (×109/L) P Morphological CR rate in first course (%) P
A 13 7/6 0.54†0.93‡0.45§ 62.4 (36–168) 0.32†0.84‡0.86§ 10.1 ± 13.5 0.21†0.33‡0.55§ 92 0.046†*0.017‡*0.10§
B 31 16/15 0.53||0.10 78.0 (32–166) 0.15||0.18 43.0 ± 62.2 0.93||0.68 80 0.55||0.83
C 25 15/10 0.31†† 71.0 (20–158) 0.99†† 25.8 ± 28.8 0.92†† 68 0.47††
D 23 17/6 / 66.0 (10–168) / 35.3 ± 41.5 / 58 /
eISSN:
1875-855X
Language:
English
Publication timeframe:
6 times per year
Journal Subjects:
Medicine, Assistive Professions, Nursing, Basic Medical Science, other, Clinical Medicine
Journal RSS Feed