Clinical Prognostic Factors in 86 Chinese Patients with Primary Myelodysplastic Syndromes and Trisomy 8: A Single Institution Experience
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The objective was to determine the characteristics and prognostic factors of 86 Chinese patients with trisomy 8 aberrationsand compare the prognostic value of International Prognostic System (IPSS) and Revised IPSS (IPSS-R) in this cohort. Materials and Methods: A total of 86 cases diagnosed with primary myelodysplastic syndromes (MDS) with isolated tr8 or with tr8 and other additional cytogenetic aberrations diagnosed and treated at the Union Hospital, Tongji Medical College of Huazhong University of Science and Technology between July 2002 and March 2013 were reviewed. Results: The median survival of the entire group was 23.0 months, and acute myeloid leukemia (AML) developed in 43% (37/86) patients within the follow up time. The univariate analysis revealed that overall survival (OS) was correlated with age, thrombocytopenia,absolute neutrophil count, marrow blasts, cytogenetic status and red blood cell transfusion at diagnosis, and the multivariateanalysis revealed that age, marrow blasts, cytogenetic status and transfusion dependence were independent parameters for the OS. The cytogenetic complexity and marrow blasts had the strongest impact on the AML transformation by multivariate analysis. Comparing the two prognostic systems, both two systems could successfully discriminate risk groups for survival. IPSS-R was more refined than IPSS for predicting OS, but had no advantage in predicting the risk of AML development. Conclusion: This study confirmed the influence of clinical factors on the prognosis of 86 Chinese MDS patients with trisomy 8. In addition, IPSS-R can further refine prognostic discrimination in the IPSS risk categories.
Abstract
Purpose: The objective was to determine the characteristics and prognostic factors of 86 Chinese patients with trisomy 8 aberrationsand compare the prognostic value of International Prognostic System (IPSS) and Revised IPSS (IPSS-R) in this cohort. Materials and Methods: A total of 86 cases diagnosed with primary myelodysplastic syndromes (MDS) with isolated tr8 or with tr8 and other additional cytogenetic aberrations diagnosed and treated at the Union Hospital, Tongji Medical College of Huazhong University of Science and Technology between July 2002 and March 2013 were reviewed. Results: The median survival of the entire group was 23.0 months, and acute myeloid leukemia (AML) developed in 43% (37/86) patients within the follow up time. The univariate analysis revealed that overall survival (OS) was correlated with age, thrombocytopenia,absolute neutrophil count, marrow blasts, cytogenetic status and red blood cell transfusion at diagnosis, and the multivariateanalysis revealed that age, marrow blasts, cytogenetic status and transfusion dependence were independent parameters for the OS. The cytogenetic complexity and marrow blasts had the strongest impact on the AML transformation by multivariate analysis. Comparing the two prognostic systems, both two systems could successfully discriminate risk groups for survival. IPSS-R was more refined than IPSS for predicting OS, but had no advantage in predicting the risk of AML development. Conclusion: This study confirmed the influence of clinical factors on the prognosis of 86 Chinese MDS patients with trisomy 8. In addition, IPSS-R can further refine prognostic discrimination in the IPSS risk categories.
참고문헌 (36)
- Greenberg PL, "Myelodysplastic syndromes", Hematology Am Soc Hematol Educ Program, 2002, pp.136~161 (2002)
- Nimer SD, "Myelodysplastic syndromes", Blood, 111, pp.4841~4851 (2008)
- Nolte F, "Myelodysplastic syndromes: molecular pathogenesis and genomic changes", Ann Hematol, 87, pp.777~795 (2008)
- Mufti GJ, "Diagnosis and classification of myelodysplastic syndrome: International Working Group on Morphology of myelodysplastic syndrome (IWGM-MDS) consensus proposals for the definition and enumeration of myeloblasts and ring sideroblasts", Haematologica, 93, pp.1712~1717 (2008)
- Solé F, "Identification of novel cytogenetic markers with prognostic significance in a series of 968 patients with primary myelodysplastic syndromes", Haematologica, 90, pp.1168~1178 (2005)
- Bernasconi P, "World Health Organization classification in combination with cytogenetic markers improves the prognostic stratification of patients with de novo primary myelodysplastic syndromes", Br J Haematol, 137, pp.193~205 (2007)
- Malcovati L, "Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes", J Clin Oncol, 25, pp.3503~3510 (2007)
- Greenberg PL, "Revised international prognostic scoring system for myelodysplastic syndromes", Blood, 120, pp.2454~2465 (2012)
- Germing U, "Prognostic scoring systems in MDS", Leuk Res, 36, pp.1463~1469 (2012)
- Greenberg P, "International scoring system for evaluating prognosis in myelodysplastic syndromes", Blood, 89, pp.2079~2088 (1997)
- Paulsson K, "Trisomy 8 as the sole chromosomal aberration in acute myeloid leukemia and myelodysplastic syndromes", Pathol Biol (Paris), 55, pp.37~48 (2007)
- Irons RD, "Prevalence of MDS subtypes in Shanghai, China: a comparison of the World Health Organization and French American British classifications", Leuk Res, 30, pp.769~775 (2006)
- Qu S, "Impacts of cytogenetic categories in the Revised International Prognostic Scoring System on the prognosis of primary myelodysplastic syndromes:results of a single-center study", Leuk Lymphoma, 53, pp.940~946 (2012)
- Xiao Y, "Trisomy 8 is the most frequent cytogenetic abnormality in de novo myelodysplastic syndrome in China", Onkologie, 35, pp.100~106 (2012)
- Ma Y, "Prognostic value of trisomy 8 in primary myelodysplastic syndrome", Intern Med J, 40, pp.697~703 (2010)
- Cazzola M, "Classification and prognostic evaluation of myelodysplastic syndromes", Semin Oncol, 38, pp.627~634 (2011)
- Sloand EM, "Preferential suppression of trisomy 8 compared with normal hematopoietic cell growth by autologous lymphocytes in patients with trisomy 8 myelodysplastic syndrome", Blood, 106, pp.841~851 (2005)
- Olnes MJ, "Directed therapy for patients with myelodysplastic syndromes(MDS) by suppression of cyclin D1 with ON 01910.Na", Leuk Res, 36, pp.982~989 (2012)
- Malcovati L, "Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS)", Haematologica, 96, pp.1433~1440 (2011)
- Gonzalez Garcia JR, "Use of the International System for Human Cytogenetic Nomenclature (ISCN)", Blood, 108, pp.3952~3953 (2006)
- Chun K, "Implementation of standardized international karyotype scoring practices is needed to provide uniform and systematic evaluation for patients with myelodysplastic syndrome using IPSS criteria: An International Working Group on MDS Cytogenetics Study", Leuk Res, 34, pp.160~165 (2010)
- Vardiman JW, "The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia:rationale and important changes", Blood, 114, pp.937~951 (2009)
- Wellner JA, "On an exponential bound for the Kaplan-Meier estimator", wLifetime Data Anal, 13, pp.481~496 (2007)
- Gill RD, "Multistate life-tables and regression models", Math Popul Stud, 3, pp.259~276 (1992)
- Pozdnyakova O, "Cytogenetic abnormalities in a series of 1,029 patients with primary myelodysplastic syndromes: a report from the US with a focus on some undefined single chromosomal abnormalities", Cancer, 113, pp.3331~3340 (2008)
- Matsuda A, "Difference in clinical features between Japanese and German patients with refractory anemia in myelodysplastic syndromes", Blood, 106, pp.2633~2640 (2005)
- Lee JJ, "Comparisons of prognostic scoring systems for myelodysplastic syndromes:a Korean multicenter study", Leuk Res, 23, pp.425~432 (1999)
- Kuendgen A, "Differences in epidemiolo-gy of MDS between Western and Eastern countries: ethnic differences or environmental influence?", Leuk Res, 31, pp.103~104 (2007)
- Chen B, "Clinical and cytogenetic features of 508 Chinese patients with myelodysplastic syndrome and comparison with those in Western countries", Leukemia, 19, pp.767~775 (2005)
- Li L, "Unique cytogenetic features of primary myelodysplastic syndromes in Chinese patients", Leuk Res, 33, pp.1194~1198 (2009)
- Al Ameri A, "Significance of thrombocytopenia in myelodysplastic syndromes: associations and prognostic implications", Clin Lymphoma Myeloma Leuk, 11, pp.237~241 (2011)
- Lee JH, "Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome", Leukemia, 17, pp.305~313 (2003)
- Pereira A, "Transfusion intensity, not the cumulative red blood cell transfusion burden, determines the prognosis of patients with myelodysplastic syndrome on chronic transfusion support", Am J Hematol, 86, pp.245~250 (2011)
- Saumell S, "Prognostic value of trisomy 8 as a single anomaly and the influence of additional cytogenetic aberrations in primary myelodysplastic syndromes", Br J Haematol, 159, pp.311~321 (2012)
- Haase D, "New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients", Blood, 110, pp.4385~4395 (2007)
- Schanz J, "Coalesced multicentric analysis of 2,351 patients with myelodysplastic syndromes indicates an underestimation of poor-risk cytogenetics of myelodysplastic syndromes in the international prognostic scoring system", J Clin Oncol, 29, pp.1963~1970 (2011)
