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Monosomal karyotype in MDS: explaining the poor prognosis?
Monosomal karyotype in MDS: explaining the poor prognosis? LEUKEMIA Schanz, J., Tuechler, H., Sole, F., Mallo, M., Luno, E., Cervera, J., Grau, J., Hildebrandt, B., Slovak, M. L., Ohyashiki, K., Steidl, C., Fonatsch, C., Pfeilstoecker, M., Noesslinger, T., Valent, P., Giagounidis, A., Aul, C., Luebbert, M., Stauder, R., Krieger, O., Le Beau, M. M., Bennett, J. M., Greenberg, P., Germing, U., Haase, D. 2013; 27 (10): 1988-1995Abstract
Monosomal karyotype (MK) is associated with an adverse prognosis in patients in acute myeloid leukemia (AML). This study analyzes the prognostic impact of MK in a cohort of primary, untreated patients with myelodysplastic syndromes (MDS). A total of 431 patients were extracted from an international database. To analyze whether MK is an independent prognostic marker in MDS, cytogenetic and clinical data were explored in uni- and multivariate models regarding overall survival (OS) as well as AML-free survival. In all, 204/431 (47.3%) patients with MK were identified. Regarding OS, MK was prognostically significant in patients with = 4 abnormalities only. In highly complex karyotypes (= 5 abnormalities), MK did not separate prognostic subgroups (median OS 4.9 months in MK+ vs 5.6 months in patients without MK, P=0.832). Based on the number of abnormalities, MK-positive karyotypes (MK+) split into different prognostic subgroups (MK+ and 2 abnormalities: OS 13.4 months, MK+ and 3 abnormalities: 8.0 months, MK+ and 4 abnormalities: 7.9 months and MK+ and = 5 abnormalities: 4.9 months; P<0.01). In multivariate analyses, MK was not an independent prognostic factor. Our data support the hypothesis that a high number of complex abnormalities, associated with an instable clone, define the subgroup with the worst prognosis in MDS, independent of MK.
View details for DOI 10.1038/leu.2013.187
View details for Web of Science ID 000325642600005
View details for PubMedID 23787396