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Outcome of Allogeneic Stem Cell Transplantation in Myelodysplastic Syndrome Patients: Prognostic implication of monosomal karyotype.
MedLine Citation:
PMID:  22762733     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Monosomal karyotype (MK) is defined as the presence of two or more autosomal monosomies or a single monosomy associated with a structural abnormality. It was first described as a high-risk cytogenetic abnormality for acute myeloid leukemia and more recently in myelodysplastic syndromes (MDS). However, allotransplant outcome in MDS with MK has not been described. PATIENTS AND METHODS: We retrospectively reviewed data of 79 MDS patients who underwent allotransplant at the University of Iowa from 1990 to 2009. We recorded patients' cytogenetic data, clinical characteristics and evaluated outcome following allogeneic SCT stratified by cytogenetic classification. RESULTS: Of 79 patients, 37 (47%) had unfavorable karyotypes (23 complex karyotype, 25 abnormal chromosome 7). Twenty-four patients (30%) had MK. Twenty-four patients (30%) relapsed and 59 (74.7%) died during study period. Patients with MK had higher 2-year relapse incidence (RI)(51%vs29%; p=0.01), lower 2-year event free survival (EFS)(8%vs40%; p=0.02) and lower 2-year overall survival (OS)(6%vs41%; p=0.02) than patients without MK. We further analyzed the effect of MK in each unfavorable karyotype composite. Although the outcome was not statistically different, unfavorable karyotypes with MK patients showed a trend toward higher 2-year RI (hazard ratio [HR] 1.7; p=0.34), lower 2-year EFS (HR 1.5; p=0.29) and lower 2-year OS (HR 1.5; p=0.28) compared to unfavorable karyotypes without MK. CONCLUSION: Cytogenetic abnormalities remain an important prognostic factor for allotransplant outcome of MDS. Our results suggested poor allotransplant outcomes with high RI and low OS in MDS with MK. © 2012 John Wiley & Sons A/S.
Authors:
Kitsada Wudhikarn; Richardvan Rheeden; Christina Leopold; Pinyo Rattanaumpawan; Roger Gingrich; Margaridade Magalhaes Silverman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-4
Journal Detail:
Title:  European journal of haematology     Volume:  -     ISSN:  1600-0609     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Division of Hematology, Oncology, Blood and Marrow Transplantation, Department of Medicine, University of Iowa Hospital and Clinics, Iowa City, Iowa.
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