title: Monosomal karyotype at the time of diagnosis or transplantation predicts outcomes of allogeneic hematopoietic cell transplantation in myelodysplastic syndrome.
abstract: Various cytogenetic risk scoring systems may determine prognosis for patients with myelodysplastic syndromes (MDS). We evaluated 4 different risk scoring systems in predicting outcome after allogeneic hematopoietic cell transplantation (alloHCT). We classified 124 patients with MDS using the International Prognostic Scoring System (IPSS), the revised International Prognostic Scoring System (R-IPSS), Armand's transplantation-specific cytogenetic grouping, and monosomal karyotype (MK) both at the time of diagnosis and at alloHCT. After adjusting for other important factors, MK at diagnosis (compared with no MK) was associated with poor 3-year disease-free survival (DFS) (27% [95% confidence interval, 12% to 42%] versus 39% [95% confidence interval, 28% to 50%], P = .02) and overall survival (OS) (29% [95% confidence interval, 14% to 44%] versus 47% [95% confidence interval, 36% to 59%], P = .02). OS but not DFS was affected by MK at alloHCT. MK frequency was uncommon in low-score R-IPPS and IPSS. Although IPSS and R-IPSS discriminated good/very good groups from poor/very poor groups, patients with intermediate-risk scores had the worst outcomes and, therefore, these scores did not show a progressive linear discriminating trend. Cytogenetic risk score change between diagnosis and alloHCT was uncommon and did not influence OS. MK cytogenetics in MDS are associated with poor survival, suggesting the need for alternative or intensified approaches to their treatment.
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota. Electronic address: custun@umn.edu.
authors.forename: Celalettin
authors.initials: C
authors.lastname: Ustun
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Trottier
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Zohar
authors.initials: Z
authors.lastname: Sachs
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Todd E
authors.initials: TE
authors.lastname: DeFor
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Leyla
authors.initials: L
authors.lastname: Shune
authors.affiliation: University of Minnesota Cytogenetics, Laboratory Medicine and Pathology, Minneapolis, Minnesota.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Courville
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Shernan G
authors.initials: SG
authors.lastname: Holtan
authors.affiliation: University of Minnesota Cytogenetics, Laboratory Medicine and Pathology, Minneapolis, Minnesota.
authors.forename: Michelle
authors.initials: M
authors.lastname: Dolan
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
authors.affiliation: Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Erica D
authors.initials: ED
authors.lastname: Warlick
mesh_terms: D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009006:Monosomy; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Allogeneic hematopoietic cell transplantation; Cytogenetic scoring systems; Cytogenetics; Monosomal karyotype; Myelodysplastic syndrome; Relapse