title: The heterogeneous prognosis of patients with myelodysplastic syndrome and chromosome 5 abnormalities: how does it relate to the original lenalidomide experience in MDS?
abstract: BACKGROUND
  To define the prognosis in myelodysplastic syndrome (MDS) and deletion 5q with or without other cytogenetic abnormalities.
  
  
  METHODS
  Patients with MDS (<20% blasts) and evaluable cytogenetic studies (1966-present) were reviewed. Outcome of patients with deletion 5q or with loss of chromosome 5 (monosomy 5) was analyzed.
  
  
  RESULTS
  Of 2743 patients analyzed, 287 (10%) had deletion 5q and 216 (8%) had monosomy 5 abnormalities. The median survival was 9 months with deletion 5q, 6 months with monosomy 5, and 17 months without a chromosome 5 abnormality. Considering patients with deletion 5q, the median survival was 33 months with deletion 5q alone, 17 months with deletion 5q and 1 additional abnormality, but only 6 months to 12 months with deletion 5q and > or =2 abnormalities or chromosome 7 abnormality. Only 93 patients (3.4% of total) had lower risk MDS (international prognostic scoring system low or intermediate 1) and deletion 5q; their median survival was 29 months (2-year survival 60%), and ranged from 13-41 months depending on the presence or absence of additional chromosomal abnormalities. Among 198 patients with MDS with deletion 5q and <10% blasts (a subset now often offered lenalidomide), the median survival was 12 months. Monosomy 5 was significantly more frequently associated with advanced MDS and with other chromosomal abnormalities.
  
  
  CONCLUSIONS
  This study provided baseline expectations of outcome in different MDS subsets and deletion 5q.
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. hkantarj@mdanderson.org
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Gautam
authors.initials: G
authors.lastname: Borthakur
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Carlos
authors.initials: C
authors.lastname: Bueso-Ramos
authors.forename: Lynne
authors.initials: L
authors.lastname: Abruzzo
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Jianqin
authors.initials: J
authors.lastname: Shan
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Issa
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
mesh_terms: D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D009006:Monosomy; D009190:Myelodysplastic Syndromes / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D012306:Risk; D016019:Survival Analysis; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D013792:Thalidomide; D000077269:Lenalidomide
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