A new prognostic index to make short-term prognoses in MDS patients treated with azacitidine: A combination of p53 expression and cytogenetics. (February 2016)

• Record Type: Journal Article
• Authors: Nishiwaki, Satoshi; Ito, Masafumi; Watarai, Rie; Okuno, Shingo; Harada, Yasuhiko; Yamamoto, Satomi; Suzuki, Kotaro; Kurahashi, Shingo; Iwasaki, Toshihiro; Sugiura, Isamu
• Is Part Of: Leukemia research. Volume 41(2016:Feb.)
• Page Start: 21
• Page End: 26
• Publication Date: 2016-02
• Subjects: Myelodysplastic syndrome -- Azacitidine -- p53 -- Prognostic index; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2015.11.014
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: p53 expression is a prognostic factor for MDS patients treated with azacitidine. Immunohistochemistry of p53 can be a simple method to analyze bone marrow clot. Combination of cytogenetics and p53 expression can make short-term prognoses. Abstract: TP53 mutation is associated with various hematological malignancies and immunohistochemistry of p53 has been used as a simple method to establish the presence of a TP53 mutation. Since the significance of p53 expression is controversial in myelodysplastic syndrome (MDS) patients treated with azacitidine (Aza), we analyzed the prevalence of p53 expression as a prognostic factor in 60 MDS patients treated with Aza. To assess p53 expression, immunohistochemical analyses of bone marrow clot sections were performed. Overall survival (OS) was significantly lower in p53-positive patients compared with p53-negetive patients (59% vs. 85% at 12 months; P = 0.006). Multivariate analysis demonstrated that p53-positive was a significant prognostic factor for OS along with poor cytogenetics. Here, we propose a new prognostic index to make short-term prognoses of MDS patients in the era of Aza treatment; high: p53-positive and poor cytogenetics, low: p53-negative and absence of poor cytogenetics, and intermediate: the others. OS was significantly different among the three groups according to this index (Low 92%, Intermediate 65% and High 27% at 12 months; P < 0.0001). In conclusion, p53 expression was a significant prognostic factor in MDS patients treated with Aza. In combination with cytogenetic abnormalities, it is possible to make short-term prognoses.