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Myelodysplasias

Monosomal karyotype in MDS: explaining the poor prognosis?

Leukemia volume 27, pages 1988–1995 (2013)Cite this article

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Abstract

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.

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Acknowledgements

We thank the MDS Foundation for its support. RS is supported by Senioren-Krebshilfe. This work was supported (in part) by grants from Institute de Salud Carlos III FEDER, Ministerio de Sanidad y Consumo (Spain): FI07/00107: PI 11/02010, and Red Temática de Investigación Cooperativa en Cáncer (RTICC, FEDER): RD07/0020/2004, RD12/0036/0044 and RD12/0036/0014.

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany

    J Schanz & D Haase

  2. L Boltzmann Institute for Leukemia Research, Vienna, Austria

    H Tüchler

  3. Institut de Recerca contra la Leucèmia Josep Carreras, Badalona, Spain

    F Solé & M Mallo

  4. Department of Hematology, University Hospital of Asturias, Oviedo, Spain

    E Luño

  5. Department of Hematology, University Hospital La Fe, Valencia, Spain

    J Cervera

  6. Department of Hematology, Hospital Germans Trias i Pujol, Barcelona, Spain

    J Grau

  7. Department of Human Genetics, University of Duesseldorf, Duesseldorf, Germany

    B Hildebrandt

  8. Sonora Quest Laboratories/Laboratory Sciences of Arizona, Cytogenetics Laboratory, Tempe, AZ, USA

    M L Slovak

  9. First Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan

    K Ohyashiki

  10. Department of Pathology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada

    C Steidl

  11. Department of Medical Genetics, Medical University of Vienna, Vienna, Austria

    C Fonatsch

  12. Hanusch Hospital, L Boltzmann Institute for Leukemia Research, Vienna, Austria

    M Pfeilstöcker & T Nösslinger

  13. Division of Hematology, Department of Medicine I, Medical University of Vienna, Vienna, Austria

    P Valent

  14. Department of Hematology and Oncology, Marien Hospital, Düsseldorf, Germany

    A Giagounidis

  15. Department of Hematology and Oncology, Johannes Hospital, Duisburg, Germany

    C Aul

  16. Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany

    M Lübbert

  17. Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria

    R Stauder

  18. Department of Internal Medicine I, Elisabethinen Hospital, Linz, Austria

    O Krieger

  19. Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA

    M M Le Beau

  20. University of Rochester, Medical Center, Rochester, NY, USA

    J M Bennett

  21. Division of Hematology, Stanford University Cancer Center, Stanford, CA, USA

    P Greenberg

  22. Department of Hematology, Oncology and Clinical Immunology, University of Duesseldorf, Düsseldorf, Germany

    U Germing

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Correspondence to J Schanz.

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Schanz, J., Tüchler, H., Solé, F. et al. Monosomal karyotype in MDS: explaining the poor prognosis?. Leukemia 27, 1988–1995 (2013). https://doi.org/10.1038/leu.2013.187

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