title: Impact of the International Prognostic Scoring System cytogenetic risk groups on the outcome of patients with primary myelodysplastic syndromes undergoing allogeneic stem cell transplantation from human leukocyte antigen-identical siblings: a retrospective analysis of the European Society for Blood and Marrow Transplantation-Chronic Malignancies Working Party.
abstract: Acquired chromosomal abnormalities are important prognostic factors in patients with myelodysplastic syndromes treated with supportive care and with disease-modifying therapeutic interventions, including allogeneic hematopoietic stem cell transplantation. To assess the prognostic impact of cytogenetic characteristics after hematopoietic stem cell transplantation accurately, we investigated a homogeneous group of 523 patients with primary myelodysplastic syndromes who have received stem cells from human leukocyte antigen-identical siblings. Overall survival at five years from transplantation in good, intermediate, and poor cytogenetic risk groups according to the International Prognostic Scoring System was 48%, 45% and 30%, respectively (P<0.01). Both the disease status (complete remission vs. not in complete remission) and the morphological classification at transplant in the untreated patients were significantly associated with probability of overall survival and relapse-free survival (P<0.01). The cytogenetic risk groups have no prognostic impact in untreated patients with refractory anemia ± ringed sideroblasts (P=0.90). However, combining the good and intermediate cytogenetic risk groups and comparing them to the poor-risk group showed within the other three disease-status-at-transplant groups a hazard ratio of 1.86 (95%CI: 1.41-2.45). In conclusion, this study shows that, in a large series of patients with primary myelodysplastic syndromes, poor-risk cytogenetics as defined by the standard International Prognostic Scoring System is associated with a relatively poor survival after allogeneic stem cell transplantation from human leukocyte antigen-identical siblings except in patients who are transplanted in refractory anemia/refractory anemia with ringed sideroblasts stage before progression to higher myelodysplastic syndrome stages.
authors.affiliation: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and University of Milan, Italy francesco.onida@unimi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Onida
authors.affiliation: University Medical Center, Leiden, the Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.affiliation: Chronic Malignancy WP Registry, Leiden, the Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: van Biezen
authors.affiliation: Radboud University - Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Schaap
authors.affiliation: University Medical Center, Leiden, the Netherlands.
authors.forename: Peter A
authors.initials: PA
authors.lastname: von dem Borne
authors.affiliation: University Hospital of Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Maertens
authors.affiliation: University Hospital, Department of Bone Marrow Transplantation, Essen, Germany.
authors.forename: Dietrich W
authors.initials: DW
authors.lastname: Beelen
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Carreras
authors.affiliation: Policlinico San Matteo, Pavia, Italy.
authors.forename: Emilio P
authors.initials: EP
authors.lastname: Alessandrino
authors.affiliation: Helsinki University Central Hospital, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Volin
authors.affiliation: University Medical Centre Utrecht, the Netherlands.
authors.forename: Jürgen H E
authors.initials: JH
authors.lastname: Kuball
authors.affiliation: Hospital de la Princesa, Madrid, Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Figuera
authors.affiliation: Hospital Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Department of Medicine-Hematology, Oncology, Freiburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Finke
authors.affiliation: University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.affiliation: Radboud University - Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000276:immunology* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D035781:Siblings; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens
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