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Incidence, characterization and prognostic significance of chromosomal abnormalities in 640 patients with primary myelodysplastic syndromes
Author(s) -
Françesc Solé,
Blanca Espinet,
G F Sanz,
José Cervera,
Marı́a José Calasanz,
Elisa Luño,
Félix Prieto,
Isabel Granada,
Jesús M. Hernández,
Juan C. Cigudosa,
José Luis Díez,
E Bureo,
Marta Marqués,
Eva Arranz,
Reuben Rios,
Joan Climent,
Teresa Vallespı́,
Lourdes Florensa,
S Woessner
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2000.01868.x
Subject(s) - international prognostic scoring system , myelodysplastic syndromes , medicine , univariate analysis , trisomy 8 , multivariate analysis , incidence (geometry) , karyotype , oncology , subgroup analysis , univariate , survival analysis , trisomy , bone marrow , multivariate statistics , chromosome , biology , gene , confidence interval , biochemistry , physics , statistics , mathematics , optics , genetics
Recently, a consensus International Prognostic Scoring System (IPSS) for predicting outcome and planning therapy in the myelodysplastic syndromes (MDS) has been developed. However, the intermediate‐risk cytogenetic subgroup defined by the IPSS includes a miscellaneous number of different single abnormalities for which real prognosis at present is uncertain. The main aims of this study were to evaluate in an independent series the prognostic value of the IPSS and to identify chromosomal abnormalities with a previously unrecognized good or poor prognosis in 640 patients. In univariate analyses, cases with single 1q abnormalities experienced poor survival, whereas those with trisomy 8 had a higher risk of acute leukaemic transformation than the remaining patients ( P = 0.004 and P = 0.009 respectively). Patients with single del(12p) had a similar survival to patients with a normal karyotype and showed some trend for a better survival than other cases belonging to the IPSS intermediate‐risk cytogenetic subgroup ( P = 0.045). Multivariate analyses demonstrated that IPSS cytogenetic prognostic subgroup, proportion of bone marrow blasts and haemoglobin level were the main prognostic factors for survival, and the first two characteristics and platelet count were the best predictors of acute leukaemic transformation risk. A large international co‐operative study should be carried out to clarify these findings.