The impact of concomitant cytogenetic abnormalities on acute myeloid leukemia with monosomy 7 or deletion 7q after HLA‐matched allogeneic stem cell transplantation

Monosomy 7 or deletion 7q (‐7/7q‐) is the most frequent adverse cytogenetic features reported in acute myeloid leukemia (AML), and is a common indication for allogeneic stem cell transplantation (SCT). Nevertheless, ‐7/7q‐ occurs frequently with other high‐risk cytogenetic abnormalities such as complex karyotype (CK), monosomal karyotype (MK), monosomy 5 or deletion 5q (‐5/5q‐), 17p abnormalities (abn(17p)) or inversion of chromosome 3 (inv(3)), the presence of which may influence the outcomes after SCT. A total of 1109 patients were allocated to this study. Two‐year probability of leukemia‐free survival (LFS) and overall survival (OS) were 30% and 36%, respectively. Two‐year probability of non‐relapse mortality (NRM) was 20%. We defined five different cytogenetic subgroups: the “‐7/7q‐ ± CK group‐ designated group1,” the “MK group‐designated group 2,” the “‐5/5q‐ group‐ designated group 3,” the “abn(17p) group‐ designated group 4” and the “inv(3) group‐ designated group 5.” The 2‐year probability of LFS in first remission was 48% for group 1, 36.4% for group 2, 28.4% for group 3, 19.1% for group 4 and 17.3% for group 5, respectively (P < .001). Multivariate analysis confirmed those significant differences across groups. Note, SCT in ‐7/7q‐ AML provides durable responses in one third of the patients. The presence of ‐7/7q‐ with or without CK in the absence of MK, abn(17p) or inv(3) is associated with a better survival after SCT. On the contrary, addition of MK, ‐5/5q‐, abn(17p) or inv(3) identifies a sub‐group of patients with poor prognosis even after SCT.