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Cytogenetics and Molecular Genetics

Impact of adjunct cytogenetic abnormalities for prognostic stratification in patients with myelodysplastic syndrome and deletion 5q

Leukemia volume 25, pages 110–120 (2011)Cite this article

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Abstract

This cooperative study assessed prognostic factors for overall survival (OS) and risk of transformation to acute myeloid leukemia (AML) in 541 patients with de novo myelodysplastic syndrome (MDS) and deletion 5q. Additional chromosomal abnormalities were strongly related to different patients’ characteristics. In multivariate analysis, the most important predictors of both OS and AML transformation risk were number of chromosomal abnormalities (P<0.001 for both outcomes), platelet count (P<0.001 and P=0.001, respectively) and proportion of bone marrow blasts (P<0.001 and P=0.016, respectively). The number of chromosomal abnormalities defined three risk categories for AML transformation (del(5q), del(5q)+1 and del(5q)+⩾2 abnormalities) and two for OS (one group: del(5q) and del(5q)+1; and del(5q)+⩾2 abnormalities, as the other one); with a median survival time of 58.0 and 6.8 months, respectively. Platelet count (P=0.001) and age (P=0.034) predicted OS in patients with ‘5q−syndrome’. This study demonstrates the importance of additional chromosomal abnormalities in MDS patients with deletion 5q, challenges the current ‘5q−syndrome’ definition and constitutes a useful reference series to properly analyze the results of clinical trials in these patients.

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Acknowledgements

This work was supported (in part) by grants from the Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Spain (FI07/00107, CA08/00141 and PI07/1009) to MM, MAS and LF, respectively; Red Temática de Investigación Cooperativa en Cáncer (RTICC and FEDER) (RD06/0020/0031 and RD07/0020/2004) to MAS and FS; the European Leukemia Net; and the National Institutes of Health (NIH) grants (5PO11CA108631) to GGM. We are grateful to the Myelodysplastic Syndromes Foundation for supporting this international project. We thank Luis Benlloch, Francesc Garcia-Pallarols and Lara Nonell, for their excellent technical assistance. We thank Encarna Bureo, Marina Recio, Virginie Eclache, Daniel Armenta-Gil, José Ángel Martínez-Climent, Isana Benet, Esperanza Vizcarra, Eva Arranz, Juan C. Cigudosa and groups belonging to the Spanish Registry of MDS, as well as the technicians involved in all cytogenetics laboratories.

Author information

Author notes

  1. M Mallo and J Cervera: These authors equally contributed to this work.

  2. G F Sanz, D Haase and F Solé: These authors equally contributed to the coordination of the project.

Authors and Affiliations

  1. Spanish Haematological Cytogenetics Working Group, Spain

    M Mallo, J Cervera, E Such, E Luño, B Espinet, T Vallespí, J Grau, J M Hernández, M J Calasanz, M L Martín, R Collado, A Valencia & F Solé

  2. Department of Cell Biology, Faculty of Life Sciences, Physiology, and Immunology, Autonomous University of Barcelona, Bellaterra, Spain

    M Mallo & F Solé

  3. Spanish MDS Registry Group, Spain

    M Mallo, J Cervera, E Such, E Luño, T Vallespí, J Grau, J M Hernández, M J Calasanz, M L Martín, R Collado, C Pedro, L Arenillas, M Á Sanz, A Valencia, L Florensa, G F Sanz & F Solé

  4. German–Austrian MDS Study Group, Germany and Austria,

    J Schanz, C Steidl, U Germing, M Pfeilstöcker, T Noesslinger, A Giagounidis, C Aul, C Fonatsch, M Lübbert, R Stauder, B Hildebrandt, O Krieger & D Haase

  5. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, USA

    G García-Manero

  6. International Working Group on Morphology of MDS (MDS Foundation),

    T Vallespí

  7. Hematology Service, University Hospital Vaudois, Lausanne, Switzerland

    S Blum

  8. Division of Hematology, The First Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan

    K Ohyashiki

  9. International Working Group on MDS Cytogenetics (MDS Foundation),

    K Ohyashiki, C Haferlach, D Haase & F Solé

  10. Department of Medicine I, Medical University of Vienna, Vienna, Austria

    P Valent

  11. Munich Leukemia Laboratory, Munich, Germany

    C Haferlach

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  1. M Mallo
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Correspondence to F Solé.

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Mallo, M., Cervera, J., Schanz, J. et al. Impact of adjunct cytogenetic abnormalities for prognostic stratification in patients with myelodysplastic syndrome and deletion 5q. Leukemia 25, 110–120 (2011). https://doi.org/10.1038/leu.2010.231

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