TY - JOUR
T1 - Acquisition of cytogenetic abnormalities in patients with IPSS defined lower-risk myelodysplastic syndrome is associated with poor prognosis and transformation to acute myelogenous leukemia
AU - Jabbour, Elias
AU - Takahashi, Koichi
AU - Wang, Xuemei
AU - Cornelison, A. Megan
AU - Abruzzo, Lynne
AU - Kadia, Tapan
AU - Borthakur, Gautam
AU - Estrov, Zeev
AU - O'Brien, Susan
AU - Mallo, Mar
AU - Wierda, William
AU - Pierce, Sherry
AU - Wei, Yue
AU - Sole, Francisco
AU - Chen, Rui
AU - Kantarjian, Hagop
AU - Garcia-Manero, Guillermo
PY - 2013/10
Y1 - 2013/10
N2 - We hypothesized that the dynamic acquisition of cytogenetic abnormalities (ACA) during the follow up of myelodysplastic syndromes (MDS) could be associated with poor prognosis. We conducted a retrospective analysis of 365 patients with IPSS low or intermediate-1 risk MDS who had at least two consecutive cytogenetic analyses during the follow up. Acquisition of cytogenetic abnormalities was detected in 107 patients (29%). The most frequent alteration involved chromosome 7 in 21% of ACA cases. Median transformation-free and overall survival for patients with and without ACA were 13 vs. 52 months (P=0.01) and 17 vs. 62 months (P=0.01), respectively. By fitting ACA as a time-dependent covariate, multivariate Cox regression analysis showed that patients with ACA had increased risk of transformation (HR=1.40; P=0.03) or death (HR=1.45; P=0.02). Notably, female patients with therapy-related MDS (t-MDS) had an increased risk of developing ACA (OR=5.26; P<0.0001), although subgroup analysis showed that prognostic impact of ACA was not evident in t-MDS. In conclusion, ACA occurs in close to one third of patients with IPSS defined lower risk MDS, more common among patients with t-MDS, but has a significant prognostic impact on de novo MDS. Am. J. Hematol. 88:831-837, 2013.
AB - We hypothesized that the dynamic acquisition of cytogenetic abnormalities (ACA) during the follow up of myelodysplastic syndromes (MDS) could be associated with poor prognosis. We conducted a retrospective analysis of 365 patients with IPSS low or intermediate-1 risk MDS who had at least two consecutive cytogenetic analyses during the follow up. Acquisition of cytogenetic abnormalities was detected in 107 patients (29%). The most frequent alteration involved chromosome 7 in 21% of ACA cases. Median transformation-free and overall survival for patients with and without ACA were 13 vs. 52 months (P=0.01) and 17 vs. 62 months (P=0.01), respectively. By fitting ACA as a time-dependent covariate, multivariate Cox regression analysis showed that patients with ACA had increased risk of transformation (HR=1.40; P=0.03) or death (HR=1.45; P=0.02). Notably, female patients with therapy-related MDS (t-MDS) had an increased risk of developing ACA (OR=5.26; P<0.0001), although subgroup analysis showed that prognostic impact of ACA was not evident in t-MDS. In conclusion, ACA occurs in close to one third of patients with IPSS defined lower risk MDS, more common among patients with t-MDS, but has a significant prognostic impact on de novo MDS. Am. J. Hematol. 88:831-837, 2013.
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U2 - 10.1002/ajh.23513
DO - 10.1002/ajh.23513
M3 - Article
C2 - 23760779
AN - SCOPUS:84884727942
SN - 0361-8609
VL - 88
SP - 831
EP - 837
JO - American journal of hematology
JF - American journal of hematology
IS - 10
ER -