Τίτλος:
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
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Papageorgiou, S.G.
Vasilatou, D.
Kontos, C.K.
Kotsianidis, I.
Symeonidis, A.
Galanopoulos, A.G.
Hatzimichael, E.
Megalakaki, A.
Poulakidas, E.
Diamantopoulos, P.
Vassilakopoulos, T.P.
Zikos, P.
Papadaki, H.
Mparmparousi, D.
Bouronikou, E.
Panayiotidis, P.
Viniou, N.-A.
Pappa, V.
Περιοδικό:
American Journal of Hematology
Εκδότης:
Wiley-Liss, Inc.
Λέξεις-κλειδιά:
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
