title: A new prognostic index to make short-term prognoses in MDS patients treated with azacitidine: A combination of p53 expression and cytogenetics.
abstract: TP53 mutation is associated with various hematological malignancies and immunohistochemistry of p53 has been used as a simple method to establish the presence of a TP53 mutation. Since the significance of p53 expression is controversial in myelodysplastic syndrome (MDS) patients treated with azacitidine (Aza), we analyzed the prevalence of p53 expression as a prognostic factor in 60 MDS patients treated with Aza. To assess p53 expression, immunohistochemical analyses of bone marrow clot sections were performed. Overall survival (OS) was significantly lower in p53-positive patients compared with p53-negetive patients (59% vs. 85% at 12 months; P=0.006). Multivariate analysis demonstrated that p53-positive was a significant prognostic factor for OS along with poor cytogenetics. Here, we propose a new prognostic index to make short-term prognoses of MDS patients in the era of Aza treatment; high: p53-positive and poor cytogenetics, low: p53-negative and absence of poor cytogenetics, and intermediate: the others. OS was significantly different among the three groups according to this index (Low 92%, Intermediate 65% and High 27% at 12 months; P<0.0001). In conclusion, p53 expression was a significant prognostic factor in MDS patients treated with Aza. In combination with cytogenetic abnormalities, it is possible to make short-term prognoses.
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan. Electronic address: n-3104@tf7.so-net.ne.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiwaki
authors.affiliation: Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ito
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Watarai
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Okuno
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Harada
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kurahashi
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Sugiura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*
chemical_list: D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D001374:Azacitidine
keywords: Azacitidine; Myelodysplastic syndrome; Prognostic index; p53