title: Partial and total monosomal karyotypes in myelodysplastic syndromes: comparative prognostic relevance among 421 patients.
abstract: Myelodysplastic syndromes (MDS) include a group of heterogeneous hematological disorders with a variable risk of leukemic evolution and short survival. Around 40-50% of patients show abnormal karyotypes that are mostly characterized by monosomies or deletions. Cytogenetic findings are an independent prognostic factor and the International prognostic scoring system (IPSS) differentiates three cytogenetic categories, despite the Intermediate one being heterogeneous. The aim of this study, including 421 Argentinean patients with primary MDS, is to characterize the cytogenetic profile, to test its prognostic value and to compare partial and monosomal karyotypes against other cytogenetic findings. An abnormal karyotype (median survival: 26 months) was observed in 176 patients. The presence of complex karyotypes, number of alterations, and the IPSS cytogenetic groups showed significant differences for predicting outcome. Behavior of patients with isolated deletions (median survival: 49 months) did not differ from those with normal karyotype (56 months, P = 0.654) or Good prognostic findings (43 months, P = 0.371). However, a worse prognosis was observed when another alteration was added (31 months, P = 0.043). Karyotypes with autosomal monosomies (median survival: 16 months) had a prognostic impact similar to other Poor cytogenetic findings (17 months, P = 0.626). In our population classified according to French-American-British (FAB) or World Health Organization (WHO), this new categorization of cytogenetic abnormalities, recognizing three different risk groups, showed an independent prognostic impact and a better discriminating power than the IPSS categories. It can be concluded that all isolate deletions (excluding 7q-) are good prognostic findings and all monosomies (excluding Y chromosome loss) are bad indicators.
authors.affiliation: Instituto de Investigaciones Hematológicas, Academia Nacional de Medicina, Buenos Aires, Argentina. cbelli@hematologia.anm.edu.ar
authors.forename: Carolina B
authors.initials: CB
authors.lastname: Belli
authors.forename: Raquel
authors.initials: R
authors.lastname: Bengió
authors.forename: Pedro Negri
authors.initials: PN
authors.lastname: Aranguren
authors.forename: Francisco
authors.initials: F
authors.lastname: Sakamoto
authors.forename: María G
authors.initials: MG
authors.lastname: Flores
authors.forename: Nora
authors.initials: N
authors.lastname: Watman
authors.forename: Elsa
authors.initials: E
authors.lastname: Nucifora
authors.forename: María V
authors.initials: MV
authors.lastname: Prates
authors.forename: Jorge
authors.initials: J
authors.lastname: Arbelbide
authors.forename: Irene
authors.initials: I
authors.lastname: Larripa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D002872:Chromosome Deletion; D002877:Chromosomes, Human / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009006:Monosomy; D009190:Myelodysplastic Syndromes / Q000235:genetics* / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate