Strickland, Stephen A.Sun, ZhuoxinKetterling, Rhett P.Cherry, Athena M.Cripe, Larry D.Dewald, GordonFernandez, HugoHicks, Gary A.Higgins, Rodney R.Lazarus, Hillard M.Litzow, Mark R.Luger, Selina M.Paietta, Elisabeth M.Rowe, Jacob M.Vance, Gail H.Wiernik, PeterWiktor, Anne E.Zhang, YanmingTallman, Martin S.2017-06-212017-06-212017-08Strickland, S. A., Sun, Z., Ketterling, R. P., Cherry, A. M., Cripe, L. D., Dewald, G., … Tallman, M. S. (2017). Independent Prognostic Significance of Monosomy 17 and Impact of Karyotype Complexity in Monosomal Karyotype/Complex Karyotype Acute Myeloid Leukemia: Results from Four ECOG-ACRIN Prospective Therapeutic Trials. Leukemia Research. https://doi.org/10.1016/j.leukres.2017.05.010https://hdl.handle.net/1805/13147The presence of a monosomal karyotype (MK+) and/or a complex karyotype (CK+) identifies subcategories of AML with poor prognosis. The prognostic significance of the most common monosomies (monosomy 5, monosomy 7, and monosomy 17) within MK+/CK+ AML is not well defined. We analyzed data from 1,592 AML patients age 17–93 years enrolled on ECOG-ACRIN therapeutic trials. The majority of MK+ patients (182/195; 93%) were MK+/CK+ with 87% (158/182) having ≥5 clonal abnormalities (CK≥ 5). MK+ patients with karyotype complexity ≤4 had a median overall survival (OS) of 0.4y compared to 1.0y for MK- with complexity ≤4 (p < 0.001), whereas no OS difference was seen in MK+ vs. MK- patients with CK≥ 5 (p = 0.82). Monosomy 5 (93%; 50/54) typically occurred within a highly complex karyotype and had no impact on OS (0.4y; p = 0.95). Monosomy 7 demonstrated no impact on OS in patients with CK≥ 5 (p = 0.39) or CK ≤ 4 (p = 0.44). Monosomy 17 appeared in 43% (68/158) of CK≥ 5 patients and demonstrated statistically significant worse OS (0.4y) compared to CK≥ 5 patients without monosomy 17 (0.5y; p = 0.012). Our data suggest that the prognostic impact of MK+ is limited to those with less complex karyotypes and that monosomy 17 may independently predict for worse survival in patients with AML.enPublisher Policyacute myeloid leukemiamonosomal karyotypecomplex karyotypeArticle