Monosomal karyotype predicts adverse prognosis in patients diagnosed with chronic myelomonocytic leukemia: A single-institution experience

Introduction Cytogenetic abnormalities have a significant prognostic effect in many hematologic neoplasms. Monosomal karyotype (MK), a newly recognized cytogenetic category, has been reported to be a marker of poor prognosis in patients with myelodysplastic syndromes and myelofibrosis, but its effect in chronic myelomonocytic leukemia (CMML) remains relatively unknown. Patients and Methods A retrospective study of cases diagnosed with CMML found a total of 262 patients. Patient characteristics, cytogenetic data, and survival were analyzed. Results Cytogenetic analysis found diploidy in 167 patients (64%). Trisomy 8 was the most frequent cytogenetic abnormality at 8% (22), followed by complex karyotype (CK) at 5% (14), ^-7 at 4% (10), and MK at 3% (7, of which 6 [86%] were also CK). Median overall survival was statistically significantly worse in MK-positive cases than in MK-negative cases (MK⁺ vs. MK^-). Patients with MK⁺ only or CK⁺MK⁺ did worse than any other group. Conclusion MK is a rare entity but can predict statistically significantly shorter overall survival among all other cytogenetic categories.