Prognostic Impact of IPSS-R and Chromosomal Translocations in 751 Korean Patients with Primary Myelodysplastic Syndrome.
Chromosomal translocations are rare in myelodysplastic syndrome (MDS) and their impact on overall survival (OS) and response to hypomethylating agents (HMA) is unknown. The prognostic impact of the revised International Prognostic Scoring System (IPSS-R) and for chromosomal translocations was assessed in 751 patients from the Korea MDS Registry. IPSS-R effectively discriminated patients according to leukaemia evolution risk and OS. We identified 40 patients (5.3%) carrying translocations, 30 (75%) of whom also fulfilled complex karyotype criteria. Translocation presence was associated with a shorter OS (median, 12.0 versus 79.7 months, P < 0.01). Multivariate analysis demonstrated that translocations (hazard ratio [HR] 1.64 [1.06-2.63]; P = 0.03) as well as age, sex, IPSS-R, and CK were independent predictors of OS. In the IPSS-R high and very high risk subgroup (n = 260), translocations remained independently associated with OS (HR 1.68 [1.06-2.69], P = 0.03) whereas HMA treatment was not associated with improved survival (median OS, 20.9 versus 21.2 months, P = 0.43). However, translocation carriers exhibited enhanced survival following HMA treatment (median 2.1 versus 12.4 months, P = 0.03). Our data suggest that chromosomal translocation is an independent predictor of adverse outcome and has an additional prognostic value in discriminating patients with MDS having higher risk IPSS-R who could benefit from HMA treatment.
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Koung Jin
http://orcid.org/0000-0002-1881-8738
KJ
Suh
Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea.
June-Won
JW
Cheong
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Inho
I
Kim
Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Chonnam, Korea.
Hyeoung-Joon
HJ
Kim
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Dong-Yeop
DY
Shin
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Youngil
Y
Koh
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Sung-Soo
SS
Yoon
Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea.
Yoo Hong
YH
Min
Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Chonnam, Korea.
Jae-Sook
JS
Ahn
Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Chonnam, Korea.
Yeo-Kyeoung
YK
Kim
Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Yun-Gyoo
YG
Lee
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.
Jeong-Ok
JO
Lee
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.
Soo-Mee
SM
Bang
Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Yeung-Chul
YC
Mun
Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Chu-Myoung
CM
Seong
Departmenet of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
Yong
Y
Park
Departmenet of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
Byung-Soo
BS
Kim
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Junshik
J
Hong
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Jinny
J
Park
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Jae Hoon
JH
Lee
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Sung-Yong
SY
Kim
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Hong Ghi
HG
Lee
D000970:Antineoplastic Agents / Q000627:therapeutic use; D019175:DNA Methylation / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014178:Translocation, Genetic / Q000187:drug effects / Q000235:genetics*; D016896:Treatment Outcome
D000970:Antineoplastic Agents