TY - JOUR
TI - The prognostic value of monosomal karyotype (MK) in higher-risk patients with myelodysplastic syndromes treated with 5-Azacitidine: A retrospective analysis of the Hellenic (Greek) Myelodysplastic syndromes Study Group
AU - Papageorgiou, S.G.
AU - Vasilatou, D.
AU - Kontos, C.K.
AU - Kotsianidis, I.
AU - Symeonidis, A.
AU - Galanopoulos, A.G.
AU - Hatzimichael, E.
AU - Megalakaki, A.
AU - Poulakidas, E.
AU - Diamantopoulos, P.
AU - Vassilakopoulos, T.P.
AU - Zikos, P.
AU - Papadaki, H.
AU - Mparmparousi, D.
AU - Bouronikou, E.
AU - Panayiotidis, P.
AU - Viniou, N.-A.
AU - Pappa, V.
JO - American Journal of Hematology
PY - 2018
VL - 93
TODO - 7
SP - 895-901
PB - Wiley-Liss, Inc.
SN - 0361-8609, 1096-8652
TODO - 10.1002/ajh.25111
TODO - azacitidine;  hemoglobin;  azacitidine, acute myeloid leukemia;  adult;  aged;  Article;  complex karyotype;  controlled study;  cytogenetics;  disease exacerbation;  drug treatment failure;  female;  follow up;  genetic association;  high risk patient;  human;  human cell;  incidence;  International Prostate Symptom Score;  karyotype;  major clinical study;  male;  monosomal karyotype;  multiple cycle treatment;  myelodysplastic syndrome;  neutrophil count;  oncogenesis and malignant transformation;  overall survival;  platelet count;  predictor variable;  priority journal;  prognosis;  retrospective study;  single drug dose;  cell transformation;  genetics;  Greece;  middle aged;  monosomy;  mortality;  myelodysplastic syndrome;  prognosis;  survival analysis;  treatment outcome;  very elderly, Adult;  Aged;  Aged, 80 and over;  Azacitidine;  Cell Transformation, Neoplastic;  Female;  Greece;  Humans;  Karyotype;  Leukemia, Myeloid, Acute;  Male;  Middle Aged;  Monosomy;  Myelodysplastic Syndromes;  Prognosis;  Retrospective Studies;  Survival Analysis;  Treatment Outcome
TODO - In this study, we investigated the incidence and prognostic impact of monosomal karyotype (MK) in 405 higher-risk Myelodysplastic Syndromes (MDS) patients treated with 5-AZA. The MK was present in 66 out of 405 (16.3%) patients, most of whom had complex karyotype (CK). MK was strongly associated with CK and the cytogenetic risk defined according to IPSS-R, as well as with high-risk disease, according to IPSS (P =.029), IPSS-R (P <.001), and WPSS (P <.001) classification systems. The overall response rate (ORR) was not different between MK+ and MK– patients (46.6% vs. 46.2%). At 28 months median follow-up, the median duration of response was 11 months in the entire cohort, 9.5 months in MK+ patients and 11 months in MK-patients (P =.024). The estimated median time to transformation to acute myeloid leukemia for MK+ patients was 17 months vs. 23 months for MK– patients (P =.025). The estimated median OS for MK+ patients was 12 months vs. 18 months for MK– patients (P <.001). Multivariate Cox regression analysis revealed that performance status (P <.001), IPSS-R (P <.001), and MK (P =.002) were independently associated with overall survival (OS). In a subgroup consisting of high and very-high risk patients according to IPSS-R, MK– patients showed better OS rates compared to MK+ patients (estimated median OS: 17 months vs. 12 months, P =.002). In conclusion, we found that MK is associated with reduced OS in patients with higher-risk MDS treated with 5-AZA. Furthermore, we showed that in MDS with high or very-high IPSS-R risk score, MK can further distinguish patients with worse outcome. © 2018 Wiley Periodicals, Inc.
ER -