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The heterogeneous prognosis of patients with myelodysplastic syndrome and chromosome 5 abnormalities

How does it relate to the original lenalidomide experience in MDS?

  1. Hagop Kantarjian MD1,†,*,
  2. Susan O'Brien MD1,
  3. Farhad Ravandi MD1,
  4. Gautam Borthakur MD1,
  5. Stefan Faderl MD1,
  6. Carlos Bueso-Ramos MD2,
  7. Lynne Abruzzo MD2,
  8. Sherry Pierce RN1,
  9. Jianqin Shan PhD1,
  10. Jean-Pierre Issa MD1,
  11. Guillermo Garcia-Manero MD1

Article first published online: 18 AUG 2009

DOI: 10.1002/cncr.24575

Issue

Cancer

Cancer

Volume 115, Issue 22, pages 5202–5209, 15 November 2009

Additional Information

How to Cite

Kantarjian, H., O'Brien, S., Ravandi, F., Borthakur, G., Faderl, S., Bueso-Ramos, C., Abruzzo, L., Pierce, S., Shan, J., Issa, J.-P. and Garcia-Manero, G. (2009), The heterogeneous prognosis of patients with myelodysplastic syndrome and chromosome 5 abnormalities. Cancer, 115: 5202–5209. doi: 10.1002/cncr.24575

Author Information

  1. 1

    Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  2. 2

    Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  1. †

    Fax: (713) 794-4297

*Department of Leukemia, Box 428, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030

Publication History

  1. Issue published online: 3 NOV 2009
  2. Article first published online: 18 AUG 2009
  3. Manuscript Accepted: 31 DEC 2008
  4. Manuscript Revised: 23 DEC 2008
  5. Manuscript Received: 17 NOV 2008

Funded by

  • Leukemia SPORE. Grant Numbers: 1P50CA100632-04, PO1CA108631
  • National Institutes of Health National Cancer Institute

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Keywords:

  • MDS;
  • deletion 5q;
  • lenalidomide

Abstract

BACKGROUND:

To define the prognosis in myelodysplastic syndrome (MDS) and deletion 5q with or without other cytogenetic abnormalities.

METHODS:

Patients with MDS (<20% blasts) and evaluable cytogenetic studies (1966-present) were reviewed. Outcome of patients with deletion 5q or with loss of chromosome 5 (monosomy 5) was analyzed.

RESULTS:

Of 2743 patients analyzed, 287 (10%) had deletion 5q and 216 (8%) had monosomy 5 abnormalities. The median survival was 9 months with deletion 5q, 6 months with monosomy 5, and 17 months without a chromosome 5 abnormality. Considering patients with deletion 5q, the median survival was 33 months with deletion 5q alone, 17 months with deletion 5q and 1 additional abnormality, but only 6 months to 12 months with deletion 5q and ≥2 abnormalities or chromosome 7 abnormality. Only 93 patients (3.4% of total) had lower risk MDS (international prognostic scoring system low or intermediate 1) and deletion 5q; their median survival was 29 months (2-year survival 60%), and ranged from 13-41 months depending on the presence or absence of additional chromosomal abnormalities. Among 198 patients with MDS with deletion 5q and <10% blasts (a subset now often offered lenalidomide), the median survival was 12 months. Monosomy 5 was significantly more frequently associated with advanced MDS and with other chromosomal abnormalities.

CONCLUSIONS:

This study provided baseline expectations of outcome in different MDS subsets and deletion 5q. Cancer 2009. © 2009 American Cancer Society.

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