| Objective: The prognostic influence of monosomal karyotype(MK)in acute myeloid leukemia(AML)has remained controversial.Therefore,we systematically evaluate the issue that wether monosomal karyotype is the independent poor prognostic factor of acute myeloid leukemia by means of meta-analysis,and explore more accurate and effective stratified therapy for acute myeloid leukemia with monosomal karyotype.Methods: To search and filter literatures through five retrieval platforms or database systems,including Pubmed,Embase,Cochrane library,Sino Med and CKNI on the Internet,whose search strategy is according to the PICOS principle of meta-analysis.Using STROBE statement and the NOS rating scale of cohort study to achieve quality assessment of literatures.Use the software of Revman5.3 to calculate and process meta-analysis data.Results: A total of 156 literatures were retrieved in the above five database systems,and 19 literatures were included in this study finally.6 out of 19 included literatures were negative publications and 13 were positive.The included literatures published from 2011 to 2017 and their areas covered Europe,Asia and America which including 2,174 patients of AML with MK(12%),with a median age of 58 years.The pooled Hazard ratios(HR)indicated MK had a poor impact on OS in AML(pooled HR:1.64,95%CI1.37-1.97,P<0.00001),and in AML with complex karyotype(CK)(pooled HR:1.46,95%CI 1.36-1.65,P<0.00001).Conclusion: Monosomal karyotype is the independent risk prognostic factor of acute myeloid leukemia.Monosomal karyotype overlaps with complex karyotype.Monosomal karyotype has heterogeneity,and may be further divided into different subgroups according to different types of monosomy,such as MK1,MK≥2.MK is a poor factor for the therapy of hematopoietic stem cell transplantation(HSCT). |
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