title: Prognostic impact of chromosomal translocations in myelodysplastic syndromes and chronic myelomonocytic leukemia patients. A study by the spanish group of myelodysplastic syndromes.
abstract: Chromosomal translocations are rare in the myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). With the exception of t(3q), translocations are not explicitly considered in the cytogenetic classification of the IPSS-R and their impact on disease progression and patient survival is unknown. The present study was aimed at determining the prognostic impact of translocations in the context of the cytogenetic classification of the IPSS-R. We evaluated 1,653 patients from the Spanish Registry of MDS diagnosed with MDS or CMML and an abnormal karyotype by conventional cytogenetic analysis. Translocations were identified in 168 patients (T group). Compared with the 1,485 patients with abnormal karyotype without translocations (non-T group), the T group had a larger proportion of patients with refractory anemia with excess of blasts and higher scores in both the cytogenetic and global IPSS-R. Translocations were associated with a significantly shorter survival and higher incidence of transformation into AML at univariate analysis but both features disappeared after multivariate adjustment for the IPSS-R cytogenetic category. Patients with single or double translocations other than t(3q) had an outcome similar to those in the non-T group in the intermediate cytogenetic risk category of the IPSS-R. In conclusion, the presence of translocations identifies a subgroup of MDS/CMML patients with a more aggressive clinical presentation that can be explained by a higher incidence of complex karyotypes. Single or double translocations other than t(3q) should be explicitly considered into the intermediate risk category of cytogenetic IPSS-R classification.
authors.affiliation: Hospital Clínic, Barcelona, Spain.|Fundació Clínic per la Recerca Biomèdica, Barcelona, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Nomdedeu
authors.affiliation: Hospital del Mar, IMIM (Institut Hospital del Mar d'lnvestigacions Mèdiques), Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvo
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Carrió
authors.affiliation: Josep Carreras Leukemia Research Institue, Campus ICO, Badalona, Spain.|ICO- Hospital Germans Trias i Pujol, UAB, Badalona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Solé
authors.affiliation: Hospital Central Universitario de Asturias, Oviedo, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Luño
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Cervera
authors.affiliation: Hospital Vall d'Hebrón, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Vallespí
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Concha
authors.initials: C
authors.lastname: Muñoz
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Cándida
authors.initials: C
authors.lastname: Gómez
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Arias
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Such
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.affiliation: ICO- Hospital Germans Trias i Pujol, UAB, Badalona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Grau
authors.affiliation: Hospital Marqués de Valdecilla, Santander, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Insunza
authors.affiliation: Universidad de Navarra, Pamplona, Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Calasanz
authors.affiliation: Hospital Txagorritxu, Vitoria, Spain.
authors.forename: María-Teresa
authors.initials: MT
authors.lastname: Ardanaz
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, Spain.|IBSAL, University of Salamanca, Salamanca, Spain.
authors.forename: Jesús-María
authors.initials: JM
authors.lastname: Hernández-Rivas
authors.affiliation: Hospital Clínico Universitario de Zaragoza, Zaragoza, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Azaceta
authors.affiliation: Centro Nacional de Investigaciones Oncológicas, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Álvarez
authors.affiliation: Hospital Reina Sofía, Córdoba, Spain.|IMIBIC, University of Córdoba, Cordoba, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sánchez
authors.affiliation: Hospital Doce de Octubre, Madrid, Spain.
authors.forename: María-Luisa
authors.initials: ML
authors.lastname: Martín
authors.affiliation: Hospital Son Llàtzer, Mallorca, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Bargay
authors.affiliation: Hospital Universitario de La Princesa, Madrid, Spain.
authors.forename: Valle
authors.initials: V
authors.lastname: Gómez
authors.affiliation: Hospital Virgen de la Luz, Cuenca, Spain.
authors.forename: Carlos-Javier
authors.initials: CJ
authors.lastname: Cervero
authors.affiliation: Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Allegue
authors.affiliation: Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Collado
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Elías
authors.initials: E
authors.lastname: Campo
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Benet
authors.initials: B
authors.lastname: Nomdedeu
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Costa
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007621:Karyotyping; D015477:Leukemia, Myelomonocytic, Chronic / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics*; D011379:Prognosis; D013030:Spain; D015996:Survival Rate; D014178:Translocation, Genetic