Prognostic impact of IPSS-R and chromosomal translocations in 751 Korean patients with primary myelodysplastic syndrome

Koung Jin Suh, June Won Cheong, Inho Kim, Hyeoung Joon Kim, Dong Yeop Shin, Youngil Koh, Sung Soo Yoon, Yoo Hong Min, Jae Sook Ahn, Yeo Kyeoung Kim, Yun Gyoo Lee, Jeong Ok Lee, Soo Mee Bang, Yeung Chul Mun, Chu Myoung Seong, Yong Park, Byung Soo Kim, Junshik Hong, Jinny Park, Jae Hoon LeeSung Yong Kim, Hong Ghi Lee

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Abstract

Chromosomal translocations are rare in myelodysplastic syndrome (MDS) and their impact on overall survival (OS) and response to hypomethylating agents (HMA) is unknown. The prognostic impact of the revised International Prognostic Scoring System (IPSS-R) and for chromosomal translocations was assessed in 751 patients from the Korea MDS Registry. IPSS-R effectively discriminated patients according to leukaemia evolution risk and OS. We identified 40 patients (5.3%) carrying translocations, 30 (75%) of whom also fulfilled complex karyotype criteria. Translocation presence was associated with a shorter OS (median, 12.0 versus 79.7 months, P < 0.01). Multivariate analysis demonstrated that translocations (hazard ratio [HR] 1.64 [1.06-2.63]; P = 0.03) as well as age, sex, IPSS-R, and CK were independent predictors of OS. In the IPSS-R high and very high risk subgroup (n = 260), translocations remained independently associated with OS (HR 1.68 [1.06-2.69], P = 0.03) whereas HMA treatment was not associated with improved survival (median OS, 20.9 versus 21.2 months, P = 0.43). However, translocation carriers exhibited enhanced survival following HMA treatment (median 2.1 versus 12.4 months, P = 0.03). Our data suggest that chromosomal translocation is an independent predictor of adverse outcome and has an additional prognostic value in discriminating patients with MDS having higher risk IPSS-R who could benefit from HMA treatment.

Original languageEnglish
Article numbere0166245
JournalPLoS One
Volume11
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

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ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Suh, K. J., Cheong, J. W., Kim, I., Kim, H. J., Shin, D. Y., Koh, Y., Yoon, S. S., Min, Y. H., Ahn, J. S., Kim, Y. K., Lee, Y. G., Lee, J. O., Bang, S. M., Mun, Y. C., Seong, C. M., Park, Y., Kim, B. S., Hong, J., Park, J., ... Lee, H. G. (2016). Prognostic impact of IPSS-R and chromosomal translocations in 751 Korean patients with primary myelodysplastic syndrome. PLoS One, 11(11), [e0166245]. https://doi.org/10.1371/journal.pone.0166245