title: New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients.
abstract: We have generated a large, unique database that includes morphologic, clinical, cytogenetic, and follow-up data from 2124 patients with myelodysplastic syndromes (MDSs) at 4 institutions in Austria and 4 in Germany. Cytogenetic analyses were successfully performed in 2072 (97.6%) patients, revealing clonal abnormalities in 1084 (52.3%) patients. Numeric and structural chromosomal abnormalities were documented for each patient and subdivided further according to the number of additional abnormalities. Thus, 684 different cytogenetic categories were identified. The impact of the karyotype on the natural course of the disease was studied in 1286 patients treated with supportive care only. Median survival was 53.4 months for patients with normal karyotypes (n = 612) and 8.7 months for those with complex anomalies (n = 166). A total of 13 rare abnormalities were identified with good (+1/+1q, t(1q), t(7q), del(9q), del(12p), chromosome 15 anomalies, t(17q), monosomy 21, trisomy 21, and -X), intermediate (del(11q), chromosome 19 anomalies), or poor (t(5q)) prognostic impact, respectively. The prognostic relevance of additional abnormalities varied considerably depending on the chromosomes affected. For all World Health Organization (WHO) and French-American-British (FAB) classification system subtypes, the karyotype provided additional prognostic information. Our analyses offer new insights into the prognostic significance of rare chromosomal abnormalities and specific karyotypic combinations in MDS.
authors.affiliation: Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany. haase.onkologie@med.uni-goettingen.de
authors.forename: Detlef
authors.initials: D
authors.lastname: Haase
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
authors.forename: Julie
authors.initials: J
authors.lastname: Schanz
authors.forename: Michael
authors.initials: M
authors.lastname: Pfeilstöcker
authors.forename: Thomas
authors.initials: T
authors.lastname: Nösslinger
authors.forename: Barbara
authors.initials: B
authors.lastname: Hildebrandt
authors.forename: Andrea
authors.initials: A
authors.lastname: Kundgen
authors.forename: Michael
authors.initials: M
authors.lastname: Lübbert
authors.forename: Regina
authors.initials: R
authors.lastname: Kunzmann
authors.forename: Aristoteles A N
authors.initials: AA
authors.lastname: Giagounidis
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.forename: Lorenz
authors.initials: L
authors.lastname: Trümper
authors.forename: Otto
authors.initials: O
authors.lastname: Krieger
authors.forename: Reinhard
authors.initials: R
authors.lastname: Stauder
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Müller
authors.forename: Friedrich
authors.initials: F
authors.lastname: Wimazal
authors.forename: Peter
authors.initials: P
authors.lastname: Valent
authors.forename: Christa
authors.initials: C
authors.lastname: Fonatsch
authors.forename: Christian
authors.initials: C
authors.lastname: Steidl
mesh_terms: D001317:Austria / Q000453:epidemiology; D002869:Chromosome Aberrations; D002965:Classification; D020732:Cytogenetic Analysis; D016208:Databases, Factual; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007621:Karyotyping; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000175:diagnosis / Q000235:genetics*; D011379:Prognosis; D015996:Survival Rate