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Blood, 1 June 2007, Vol. 109, No. 11, pp. 4641-4647. Prepublished online as a Blood First Edition Paper on February 13, 2007; DOI 10.1182/blood-2006-10-051342.
CLINICAL TRIALS AND OBSERVATIONS Monosomy 7 and deletion 7q in children and adolescents with acute myeloid leukemia: an international retrospective study1 Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark; 2 Children's Oncology Group, University of Southern California, Los Angeles; 3 French Leucémie Aique Myeloide Enfant (LAME), Hôpital Trousseau, Paris, France; 4 Hôpital Americain, Reims, France; 5 Pediatric Oncology Group Statistical Office, Gainesville, FL; 6 AML-BFM Trials, Pediatric Hematology/Oncology, University Hospital Münster, Germany; 7 Department of Pediatrics and Adolescent Medicine, University of Freiburg, Germany; 8 Department of Clinical Science, Pediatrics, Umeå University Hospital, Sweden; 9 Servicio de Hematologia, Hospital de Ninos S. M. Ludovica, La Plata, Argentina; 10 Children's Cancer Research Institute (CCRI), Vienna, Austria; 11 St Anna Children's Hospital, Vienna, Austria; 12 Department of Pediatric Hematology and Oncology, University of Giessen, Germany; 13 Leukaemia Research Fund Group, University of Southampton, United Kingdom; 14 Department of Pathology, The Ohio State University, Columbus; 15 Dutch Childhood Oncology Group (DCOG), Rotterdam, The Netherlands; 16 Department of Pediatric Oncology/Hematology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands; 17 AML Committee I-BFM-SG, Department of Pediatric Hematology/Oncology, Vrije Universiteit (VU) University Medical Center, Amsterdam, The Netherlands; 18 Oncoematologia Pediatrica, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Italy; 19 Department of Pediatric Hematology/Oncology, Aghia Sophia Children's Hospital, Athens, Greece; 20 Wayne State University, Department of Pediatrics, Children's Hospital of Michigan, Detroit; 21 St Jude Children's Research Hospital, Memphis, TN; 22 AML-BFM Trials, Pediatric Hematology/Oncology, Medical School, Hannover, Germany; 23 Department of Hematology, National Research Center for Pediatric Oncology and Hematology, Minsk, Belarus; 24 Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel; 25 European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium; 26 Department of Pediatrics, Toho University School of Medicine, Otaku, Tokyo, Japan; 27 Great Ormond Street Hospital for Children, London, United Kingdom; 28 Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Poland; 29 Children's Healthcare of Atlanta, Emory University, Atlanta, GA; 30 Department of Pathology, St Jude Children's Research Hospital, Memphis, TN Monosomy 7 (–7) and deletion 7q \del(7q)] are rare in childhood acute myeloid leukemia (AML). We retrospectively collected data on 258 children with AML or refractory anemia with excess blasts in transformation (RAEB-T) and –7 or del(7q) with or without other cytogenetic aberrations \± other]. Karyotypes included –7 (n = 90), –7 other (n = 82), del(7q) (n = 21), and del(7q) other (n = 65). Complete remission (CR) was achieved in fewer patients with –7 ± other compared with del(7q) ± other (61% versus 89%, P < .001). Overall, the 5-year survival rate was 39% (SE, 3%). Survival was superior in del(7q) ± other compared with –7 ± other (51% versus 30%, P < .01). Cytogenetic aberrations considered favorable in AML \t(8;21)(q22;q22), inv(16)(p13q22), t(15;17)(q22;q21), t(9;11)(p22;q23)] (n = 24) were strongly associated with del(7q) and a higher 5-year survival rate compared with del(7q) without favorable cytogenetics (75% versus 46%, P = .03). Patients with –7 and inv(3),–5/del(5q), or + 21 had a 5-year survival rate of 5%. Stem cell transplantation analyzed as a time-dependent variable had no impact on overall survival. However, patients not achieving CR had a 31% survival rate after stem cell transplantation. Childhood AML with chromosome 7 aberrations represents a heterogeneous group of disorders with additional cytogenetic aberrations having a major prognostic impact which should be reflected in future risk-group stratification.
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