Monosomal karyotype in MDS: explaining the poor prognosis?

Autores de IIS La Fe

• José Vicente Cervera Zamora

  Autor

Participantes ajenos a IIS La Fe

• Schanz J
• Tüchler H
• Solé F
• Mallo M
• Luño E
• Grau J
• Hildebrandt B
• Slovak ML
• Ohyashiki K
• Steidl C
• Fonatsch C
• Pfeilstöcker M
• Nösslinger T
• Valent P
• Giagounidis A
• Aul C
• Lübbert M
• Stauder R
• Krieger O
• Le Beau MM
• Bennett JM
• Greenberg P
• Germing U
• Haase D

Grupos

• Hematología y Hemoterapia

Abstract

Monosomal karyotype (MK) is associated with an adverse prognosis in patients in acute myeloid leukemia (AML). This study analyzes the prognostic impact of MK in a cohort of primary, untreated patients with myelodysplastic syndromes (MDS). A total of 431 patients were extracted from an international database. To analyze whether MK is an independent prognostic marker in MDS, cytogenetic and clinical data were explored in uni- and multivariate models regarding overall survival (OS) as well as AML-free survival. In all, 204/431 (47.3%) patients with MK were identified. Regarding OS, MK was prognostically significant in patients with = 4 abnormalities only. In highly complex karyotypes (= 5 abnormalities), MK did not separate prognostic subgroups (median OS 4.9 months in MK+ vs 5.6 months in patients without MK, P=0.832). Based on the number of abnormalities, MK-positive karyotypes (MK+) split into different prognostic subgroups (MK+ and 2 abnormalities: OS 13.4 months, MK+ and 3 abnormalities: 8.0 months, MK+ and 4 abnormalities: 7.9 months and MK+ and = 5 abnormalities: 4.9 months; P<0.01). In multivariate analyses, MK was not an independent prognostic factor. Our data support the hypothesis that a high number of complex abnormalities, associated with an instable clone, define the subgroup with the worst prognosis in MDS, independent of MK.