Detailed analysis of clonal evolution and cytogenetic evolution patterns in patients with myelodysplastic syndromes (MDS) and related myeloid disorders.

Schanz, Julie; Cevik, Naciye; Fonatsch, Christa; Braulke, Friederike; Shirneshan, Katayoon; Bacher, Ulrike; Haase, Detlef (2018). Detailed analysis of clonal evolution and cytogenetic evolution patterns in patients with myelodysplastic syndromes (MDS) and related myeloid disorders. Blood cancer journal, 8(3), p. 28. Nature Publishing Group 10.1038/s41408-018-0061-z

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Clonal cytogenetic evolution (CE) (i.e., acquisition of new chromosomal aberrations over time) is relevant for the progression of myelodysplastic syndromes (MDS). We performed detailed analysis of CE in 729 patients with MDS and related disorders. Patients with CE showed shorter survival (median OS 18.0 versus 53.9 months; P < 0.01), higher leukemic transformation rate (48.0% versus 21.4%; P < 0.01) and shorter intervals to leukemic transformation (P < 0.01). Two main CE patterns were detected: early versus late CE (median onset 5.3 versus 21.9 months; P < 0.01) with worse survival outcomes for early CE. In the case of CE, del (7q)/-7 (P = 0.020) and del (17p) (P = 0.002) were especially unfavorable. Extending the evolution patterns from Tricot et al. (1985) forming five subgroups, prognosis was best (median OS not reached) in patients with "transient clones/changing clone size", whereas those with "CE at diagnosis" showed very poor outcomes (P < 0.01 for comparison of all). Detailed sequential cytogenetic analysis during follow-up improves prognostication in MDS patients and acknowledges the dynamic biology of the disease. Evidence, time-point, and patterns of cytogenetic clonal evolution should be included into future prognostic scoring systems for MDS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Bacher, Vera Ulrike

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2044-5385

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

20 Aug 2018 14:26

Last Modified:

10 Mar 2021 04:33

Publisher DOI:

10.1038/s41408-018-0061-z

PubMed ID:

29515104

BORIS DOI:

10.7892/boris.119317

URI:

https://boris.unibe.ch/id/eprint/119317

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