SOME PROGNOSTIC FACTORS IN MDS AND LEUKEMIA ABNORMALITY GOOD INTERMEDIATE BAD
COMMENTS
AML DE NOVO X SECONDARY Th-RELATED CHROMOSOMES Normal karyotype
X XX X
MULTIPLE CYTOGENETIC ABNORMALITIES
X
Inv(3)(q21;q26)/ t(3;3)(q21;q26) -7 +8 +21 + 22 +11 +13 Abnormal(17p) t(9;22) t(6;9)(p23;q34) t(6;11) Del(5q) Del(7q) Del(9q) -5, 5q3,5,7 complex karyotype t(11;19) 11q23 abnormalities Abnormal 20q X or Y cytogenetic Abnormalities alone t(15:17)(q22;q12) t(8;21)(q22;q22) Inv(16)(p13;q22)/ t(16;16)(p13;q22) GENES WT1 mutations NPM1
X X X X X
X X X X X X X X X X X X X X X X X
Nucleophosmin 1
CEBP-A FLT3-ITD MLL-PTD
CCAAT/enhancer binding protein- α
X X X
KIT AML1
X ?
Over expression ERG,EVI1,BALLC, MN1 P53
ALL
Childhood Female gender Age >2<10 yrs Adulthood
X
X X X X X X X X X X X
The more severe cytopenia the worse is prognosis
X X X
Higher leukemic transformation
X
Combined 5 & 7 Del (12p) Normal Karyotype Complex abnormality
Ets Related gene, Ecotropic viral integration site-1, Brain and acute leukemia cytoplasmic
X
High leukocyte count at presentation
T(9;22) Polyploidy B- ALL Pre-B ALL (cALL) MDS ↑blasts in marrow Cytopenia ↓Neut ↓Hct ↓Plat Need for therapy Trisomy 8 Ch 7 abnormalities Ch 5 abnormalities
Partial tandem duplications of the mixed-lineage leukemia gene
5q- in RAEB: bad sign 5q- with other ch abnormalities: bad
X X X? X
+1 or +1q t(1q) t(7q) Del 9q
X X X X X X X X X
Ch. 15 abnormalities
t(17q) Monosomy 21 Trisomy 21 -X del (11q) Ch 19 abnormalities t(5q) X
X X
2
AML1 gene in tMDS
Therapy-related Del(20) -y P53 mutation Pediatric MDS
X X X X X X
In primary MDS
Akram Al-Hilali 2012
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