<prompt> Bad prognosis in AML is indicated by aEURMonosomyDeletion of X or Y chromosomeT 8 : 21Nucleophosmin mutation  <response>: Monosomy Prognostic factors in AML Favourable prognostic factors Unourable prognostic factors Miscellaneous prognostic factors Age 40 yrs del 7q In recent years, with availability AML without antecedent MDS MPD dui 5q of markers on bone marrow Blast cells with Auer rods 11q23 - MLL ve trephine sections, it has been TLC 25 x 109L 3q21 possible to study antiogenesis, t 15;17 in AML - M3- PMURARA ve Expression of MDR-1 gene Multidrug proliferative index, apoptosis and t 8;21 in AML-M, Inv 16 in AML- M4Eo resistance gene 3q26 other parameters FAB subtype - AML- M2, M3, M4 Complex karyotypes High WBC count 100 x 109L AML with preceeding MDS PMD Extremes of age 2 years and 55 years FLT-3 mutation -77q Extramedullary disease in AML- M5 Presence of CNS involvement FAB subtype AML -MO, M6, M7 -- t 8 ; 21Q in AML - M2 Good prognosis Inv 16 in AML- M4 E,, t 15 ; 17Q in AML - M3 - PML RAFA ve Moderately ourable outome No cytogenetic abnormality Q del 7q Monosomy 5 or 7 del 5q inv 3 q 21. q 26 11123 - MLL ve t 3;3 Poor prognosis 3q21 t 6:11 Expression of MDR-1 gene t 10:11 3q26 t 9;22 Genetic abnormalities in normal cytogenetic AML Name Prognosis Prevalence Expression NPM-1 nuclephosmin Favourable 50-60 Mutation FLT3-ITD The Ems - like tyrosine kinase 3 Gene Unourable 3040 Mutation FLT3 -Asp835 Unclear 5 - 10 Mutation BAALC Brain and acute leukemia cytoplasmic Unourable 65.7 Over expression MNI Meningioma I Unourable 50 Over expression MLI -PTD Mixed lineage leukemia Unourable 7.7 Mutation over expression CEBPa CCATEnhancer binding protein alpha gene Favour able 15 - 20 Mutation ERG-I The E1S-related gene Unoruable 25 Over expression AF-lq expression Unourable 75 Over expression Nuleophosmin NPM1 mutations The most common molecular abnormality present in -50 of AMLs with normal karyotype. nK- AML constitutes -45 of AMLs and conveys an intermediate but heterogenous prognosis. Exon 12 NEM mutations always 4bp inseions disrupt a key regulatory region. AML with mutated NPM nusleophosmin has a ourable prognosis. Loss of X.Y chromosome There is a correlation between t 8;21 and involvement of sex chromosomes X, Y chromosomes - Involvement of sex chromosome occur in cases with t 8;21 that may be either in the .form of loss of X chromosome or duplication of Y chromosome. - Loss of the Y chromosome or loss of the X chromosome is associated with t 8;21 in 80 to 90 cases. - But the significance of these abnormalities on prognosis is not clear. Most probably they have ourable prognosis just as t8;21. 