Prognostic impact of a suboptimal number of analyzed metaphases in normal karyotype lower-risk MDS. (April 2018)

• Record Type: Journal Article
• Authors: de Swart, Louise; Smith, Alex; Haase, Detlef; Fenaux, Pierre; Symeonidis, Argiris; Cermak, Jaroslav; Sanz, Guillermo; Stauder, Reinhard; Mittelman, Moshe; Hellström-Lindberg, Eva; Malcovati, Luca; Langemeijer, Saskia; Skov-Holm, Mette; Mądry, Krzysztof; Germing, Ulrich; Almeida, Antonio Medina; Tatic, Aurelia; Savic, Aleksandar; Šimec, Njetočka Gredelj; van Marrewijk, Corine; Guerci-Bresler, Agnes; Sanhes, Laurence; Luño, Elisa; Culligan, Dominic; Beyne-Rauzy, Odile; Burgstaller, Sonja; Blijlevens, Nicole; Bowen, David; de Witte, Theo
• Is Part Of: Leukemia research. Volume 67(2018)
• Page Start: 21
• Page End: 26
• Publication Date: 2018-04
• Subjects: Myelodysplastic syndromes -- Metaphases -- Karyotype -- Cytogenetics -- Lower-risk -- Overall survival -- Progression-free survival; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2018.01.022
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Outcome in normal karyotype and suboptimal number of metaphases was not inferior. Abnormal karyotype and suboptimal number of metaphases did not impact outcome. It should be a general aim to reach a complete analysis of 20 metaphases. If not possible, we recommend to use complementary FISH-analyses. Abstract: 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.