title: Monosomal karyotype in MDS: explaining the poor prognosis?
abstract: Monosomal karyotype (MK) is associated with an adverse prognosis in patients in acute myeloid leukemia (AML). This study analyzes the prognostic impact of MK in a cohort of primary, untreated patients with myelodysplastic syndromes (MDS). A total of 431 patients were extracted from an international database. To analyze whether MK is an independent prognostic marker in MDS, cytogenetic and clinical data were explored in uni- and multivariate models regarding overall survival (OS) as well as AML-free survival. In all, 204/431 (47.3%) patients with MK were identified. Regarding OS, MK was prognostically significant in patients with ≤ 4 abnormalities only. In highly complex karyotypes (≥ 5 abnormalities), MK did not separate prognostic subgroups (median OS 4.9 months in MK+ vs 5.6 months in patients without MK, P=0.832). Based on the number of abnormalities, MK-positive karyotypes (MK+) split into different prognostic subgroups (MK+ and 2 abnormalities: OS 13.4 months, MK+ and 3 abnormalities: 8.0 months, MK+ and 4 abnormalities: 7.9 months and MK+ and ≥ 5 abnormalities: 4.9 months; P<0.01). In multivariate analyses, MK was not an independent prognostic factor. Our data support the hypothesis that a high number of complex abnormalities, associated with an instable clone, define the subgroup with the worst prognosis in MDS, independent of MK.
authors.affiliation: Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schanz
authors.forename: H
authors.initials: H
authors.lastname: Tüchler
authors.forename: F
authors.initials: F
authors.lastname: Solé
authors.forename: M
authors.initials: M
authors.lastname: Mallo
authors.forename: E
authors.initials: E
authors.lastname: Luño
authors.forename: J
authors.initials: J
authors.lastname: Cervera
authors.forename: J
authors.initials: J
authors.lastname: Grau
authors.forename: B
authors.initials: B
authors.lastname: Hildebrandt
authors.forename: M L
authors.initials: ML
authors.lastname: Slovak
authors.forename: K
authors.initials: K
authors.lastname: Ohyashiki
authors.forename: C
authors.initials: C
authors.lastname: Steidl
authors.forename: C
authors.initials: C
authors.lastname: Fonatsch
authors.forename: M
authors.initials: M
authors.lastname: Pfeilstöcker
authors.forename: T
authors.initials: T
authors.lastname: Nösslinger
authors.forename: P
authors.initials: P
authors.lastname: Valent
authors.forename: A
authors.initials: A
authors.lastname: Giagounidis
authors.forename: C
authors.initials: C
authors.lastname: Aul
authors.forename: M
authors.initials: M
authors.lastname: Lübbert
authors.forename: R
authors.initials: R
authors.lastname: Stauder
authors.forename: O
authors.initials: O
authors.lastname: Krieger
authors.forename: M M
authors.initials: MM
authors.lastname: Le Beau
authors.forename: J M
authors.initials: JM
authors.lastname: Bennett
authors.forename: P
authors.initials: P
authors.lastname: Greenberg
authors.forename: U
authors.initials: U
authors.lastname: Germing
authors.forename: D
authors.initials: D
authors.lastname: Haase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009006:Monosomy / Q000235:genetics*; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000235:genetics / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult