TY - JOUR
T1 - Multicenter validation study of a transplantation-specific cytogenetics grouping scheme for patients with myelodysplastic syndromes
AU - Armand, P.
AU - Deeg, H. J.
AU - Kim, H. T.
AU - Lee, H.
AU - Armistead, P.
AU - De Lima, M.
AU - Gupta, V.
AU - Soiffer, R. J.
N1 - Funding Information:
This work was funded in part by NIAID U19 AI 29530, PO1 HL070149 from the National Heart, Lung and Blood Institute, and the Ted and Eileen Pasquarello Research Fund. PA is also supported by a fellowship from the Leukemia and Lymphoma Society. HJD is supported by NIH grants HL036444, HL082941 and CA018029.
PY - 2010/5
Y1 - 2010/5
N2 - Cytogenetics is an important prognostic factor for patients with myelodysplastic syndromes (MDS). However, existing cytogenetics grouping schemes are based on patients treated with supportive care, and may not be optimal for patients undergoing allo-SCT. We proposed earlier an SCT-specific cytogenetics grouping scheme for patients with MDS and AML arising from MDS, based on an analysis of patients transplanted at the Dana-Farber Cancer Institute/Brigham and Women's Hospital. Under this scheme, abnormalities of chromosome 7 and complex karyotype are considered adverse risk, whereas all others are considered standard risk. In this retrospective study, we validated this scheme on an independent multicenter cohort of 546 patients. Adverse cytogenetics was the strongest prognostic factor for outcome in this cohort. The 4-year relapse-free survival and OS were 42 and 46%, respectively, in the standard-risk group, vs 21 and 23% in the adverse group (P < 0.0001 for both comparisons). This grouping scheme retained its prognostic significance irrespective of patient age, disease type, earlier leukemogenic therapy and conditioning intensity. Therapy-related disease was not associated with increased mortality in this cohort, after taking cytogenetics into account. We propose that this SCT-specific cytogenetics grouping scheme be used for patients with MDS or AML arising from MDS who are considering or undergoing SCT.
AB - Cytogenetics is an important prognostic factor for patients with myelodysplastic syndromes (MDS). However, existing cytogenetics grouping schemes are based on patients treated with supportive care, and may not be optimal for patients undergoing allo-SCT. We proposed earlier an SCT-specific cytogenetics grouping scheme for patients with MDS and AML arising from MDS, based on an analysis of patients transplanted at the Dana-Farber Cancer Institute/Brigham and Women's Hospital. Under this scheme, abnormalities of chromosome 7 and complex karyotype are considered adverse risk, whereas all others are considered standard risk. In this retrospective study, we validated this scheme on an independent multicenter cohort of 546 patients. Adverse cytogenetics was the strongest prognostic factor for outcome in this cohort. The 4-year relapse-free survival and OS were 42 and 46%, respectively, in the standard-risk group, vs 21 and 23% in the adverse group (P < 0.0001 for both comparisons). This grouping scheme retained its prognostic significance irrespective of patient age, disease type, earlier leukemogenic therapy and conditioning intensity. Therapy-related disease was not associated with increased mortality in this cohort, after taking cytogenetics into account. We propose that this SCT-specific cytogenetics grouping scheme be used for patients with MDS or AML arising from MDS who are considering or undergoing SCT.
KW - Allo-SCT
KW - Cytogenetics
KW - Myelodysplastic syndromes
KW - Therapy-related disease
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U2 - 10.1038/bmt.2009.253
DO - 10.1038/bmt.2009.253
M3 - Article
C2 - 19784076
AN - SCOPUS:77952427829
SN - 0268-3369
VL - 45
SP - 877
EP - 885
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 5
ER -