Cytogenetic abnormalities in a series of 1029 patients with primary myelodysplastic syndromes

A report from the US with a focus on some undefined single chromosomal abnormalities

Authors

  • Olga Pozdnyakova MD,

    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
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  • Patricia M. Miron PhD,

    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
    2. Hospital Laboratories, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts
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  • Guilin Tang MD,

    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
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  • Otto Walter MD,

    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
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  • Azra Raza MD,

    1. Myelodysplastic Syndrome Program, St. Vincent's Comprehensive Cancer Center, New York, New York
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  • Bruce Woda MD,

    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
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  • Sa A. Wang MD

    Corresponding author
    1. Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, Massachusetts
    2. Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard,Unit 72, Houston, TX 77030-4009
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    • Fax: (713) 563-3166


Abstract

BACKGROUND.

Conventional karyotype has an established role in myelodysplastic syndrome (MDS) and is included in the International Prognostic Scoring System (IPSS) for patient risk stratification and treatment selection. Although some chromosomal abnormalities have been well characterized, the significance of several miscellaneous, infrequent, single chromosomal abnormalities remains to be defined. In addition, the emerging therapeutic agents may change the natural course of disease in patients with MDS and the cytogenetic impact on risk stratification.

METHODS.

Clinicopathologic data were retrieved on 1029 patients who had a diagnosis of primary MDS and had available cytogenetic data (karyotype) on file.

RESULTS.

Cytogenetic abnormalities were identified in 458 patients (45%) and occurred most frequently in patients who had refractory anemia with excess blasts (62%). Overall, the 3 cytogenetic risk groups defined by the IPSS—good, intermediate, and poor—effectively stratified the patients' overall survival (OS) (64 months, 31 months, and 12 months, respectively; P < .001). With the exception of gain of chromosome 8, single cytogenetic abnormalities within the intermediate group were extremely infrequent in the series but demonstrated variable OS ranging from 10 months for patients who had isochromosome (17q) to 69 months for patients who had deletion of 12p [del(12p)], suggesting different prognostic significance. In the poor cytogenetic risk group, patients with isolated del(7q) and derivative (1;7)(q10;p10) had a significantly better median OS than patients who had either loss of chromosome 7 or a complex karyotype (P < .05).

CONCLUSIONS.

The current data generated from a large cohort of patients with primary MDS indicated that some specific cytogenetic abnormalities carry different risk than their IPSS cytogenetic risk-group assignment, especially in the new treatment era. Because of the extreme low frequency, additional combined studies are needed to better categorize some rare single cytogenetic abnormalities within the intermediate cytogenetic risk group. Cancer 2008. © 2008 American Cancer Society.

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