TY - JOUR
T1 - Prognostic impact of a suboptimal number of analyzed metaphases in normal karyotype lower-risk MDS
AU - de Swart, Louise
AU - Smith, Alex
AU - Haase, Detlef
AU - Fenaux, Pierre
AU - Symeonidis, Argiris
AU - Cermak, Jaroslav
AU - Sanz, Guillermo
AU - Stauder, Reinhard
AU - Mittelman, Moshe
AU - Hellström-Lindberg, Eva
AU - Malcovati, Luca
AU - Langemeijer, Saskia
AU - Skov-Holm, Mette
AU - Mądry, Krzysztof
AU - Germing, Ulrich
AU - Almeida, António Medina
AU - Tatic, Aurelia
AU - Savic, Aleksandar
AU - Šimec, Njetočka Gredelj
AU - van Marrewijk, Corine
AU - Guerci-Bresler, Agnes
AU - Sanhes, Laurence
AU - Luño, Elisa
AU - Culligan, Dominic
AU - Beyne-Rauzy, Odile
AU - Burgstaller, Sonja
AU - Blijlevens, Nicole
AU - Bowen, David
AU - de Witte, Theo
PY - 2018/4
Y1 - 2018/4
N2 - Conventional karyotype is one of the most relevant prognostic factors in MDS. However, about 50% of patients with MDS have a normal karyotype. Usually, 20–25 normal metaphases (nMP) are considered to be optimal to exclude small abnormal clones which might be associated with poor prognosis. This study evaluated the impact of examining a suboptimal number of metaphases in patients recruited to the EUMDS Registry with low and intermediate-1 risk according to IPSS. Only 179/1049 (17%) of patients with a normal karyotype had a suboptimal number of nMP, defined as less than 20 metaphases analyzed. The outcome (overall survival and progression-free survival) of patients with suboptimal nMP was not inferior to those with higher numbers of analyzed MP both in univariate and multivariate analyses. For patients with an abnormal karyotype, 224/649 (35%) had a suboptimal number of MP assessed, but this did not impact on outcome. For patients with a normal karyotype and suboptimal numbers of analyzable metaphases standard evaluation might be acceptable for general practice, but we recommend additional FISH-analyses or molecular techniques, especially in candidates for intensive interventions.
AB - Conventional karyotype is one of the most relevant prognostic factors in MDS. However, about 50% of patients with MDS have a normal karyotype. Usually, 20–25 normal metaphases (nMP) are considered to be optimal to exclude small abnormal clones which might be associated with poor prognosis. This study evaluated the impact of examining a suboptimal number of metaphases in patients recruited to the EUMDS Registry with low and intermediate-1 risk according to IPSS. Only 179/1049 (17%) of patients with a normal karyotype had a suboptimal number of nMP, defined as less than 20 metaphases analyzed. The outcome (overall survival and progression-free survival) of patients with suboptimal nMP was not inferior to those with higher numbers of analyzed MP both in univariate and multivariate analyses. For patients with an abnormal karyotype, 224/649 (35%) had a suboptimal number of MP assessed, but this did not impact on outcome. For patients with a normal karyotype and suboptimal numbers of analyzable metaphases standard evaluation might be acceptable for general practice, but we recommend additional FISH-analyses or molecular techniques, especially in candidates for intensive interventions.
KW - Cytogenetics
KW - Karyotype
KW - Lower-risk
KW - Metaphases
KW - Myelodysplastic syndromes
KW - Overall survival
KW - Progression-free survival
UR - http://www.scopus.com/inward/record.url?scp=85041672268&partnerID=8YFLogxK
U2 - 10.1016/j.leukres.2018.01.022
DO - 10.1016/j.leukres.2018.01.022
M3 - Article
C2 - 29407183
AN - SCOPUS:85041672268
SN - 0145-2126
VL - 67
SP - 21
EP - 26
JO - Leukemia Research
JF - Leukemia Research
ER -