title: Does cytogenetic evolution have any prognostic relevance in myelodysplastic syndromes? A study on 153 patients from a single institution.
abstract: The present study was designed to establish the incidence of cytogenetic evolution (CE), defined as the acquisition of chromosomal defects during the course of MDS, in order to correlate it with the WHO classification and IPSS score, and to assess its impact on overall survival (OS) and risk of MDS/AML evolution (progression-free interval, PFI) by means of Cox models for time-dependent covariates. Adjustments for known risk factors were achieved by performing a bivariable analysis. The study was carried out in 153 MDS patients who were followed for a median period of 45.2 months. Disease progression occurred in 42.4% of patients after a 65.2-month median PFI, while CE occurred in 30.7% of patients. Our study shows that (1) CE was more common in advanced than in early MDS, and advanced MDS presented secondary chromosomal defects distinct from those of early MDS; (2) CE significantly affected OS and PFI independently of other prognostic variables; (3) del(7)(q31q34) was the only secondary chromosomal defect which significantly affected PFI; trisomy 8 had only a moderate influence.
authors.affiliation: Division of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy. p.bernasconi@smatteo.pv.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Bernasconi
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Marina
authors.initials: M
authors.lastname: Boni
authors.forename: Paola Maria
authors.initials: PM
authors.lastname: Cavigliano
authors.forename: Ilaria
authors.initials: I
authors.lastname: Giardini
authors.forename: Barbara
authors.initials: B
authors.lastname: Rocca
authors.forename: Rita
authors.initials: R
authors.lastname: Zappatore
authors.forename: Irene
authors.initials: I
authors.lastname: Dambruoso
authors.forename: Celeste
authors.initials: C
authors.lastname: Calvello
authors.forename: Marilena
authors.initials: M
authors.lastname: Caresana
authors.forename: Mario
authors.initials: M
authors.lastname: Lazzarino
mesh_terms: D000368:Aged; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D002869:Chromosome Aberrations / Q000706:statistics & numerical data; D020732:Cytogenetic Analysis; D018450:Disease Progression; D019143:Evolution, Molecular; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis