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The heterogeneous prognosis of patients with myelodysplastic syndrome and chromosome 5 abnormalities
Author(s) -
Kantarjian Hagop,
O'Brien Susan,
Ravandi Farhad,
Borthakur Gautam,
Faderl Stefan,
BuesoRamos Carlos,
Abruzzo Lynne,
Pierce Sherry,
Shan Jianqin,
Issa JeanPierre,
GarciaManero Guillermo
Publication year - 2009
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.24575
Subject(s) - monosomy , medicine , lenalidomide , chromosome 7 (human) , myelodysplastic syndromes , chromosome abnormality , abnormality , cytogenetics , gastroenterology , oncology , chromosomal abnormality , cancer , chromosome , pathology , karyotype , genetics , multiple myeloma , biology , bone marrow , gene , psychiatry
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.