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Impact of the International Prognostic Scoring System cytogenetic risk groups on the outcome of patients with primary myelodysplastic syndromes undergoing allogeneic stem cell transplantation from human leukocyte antigen-identical siblings: a retrospective analysis of the European Society for Blood and Marrow Transplantation-Chronic Malignancies Working Party
Francesco Onida, Ronald Brand, Anja van Biezen, Michel Schaap, Peter A. von dem Borne, Johan Maertens, Dietrich W. Beelen, Enric Carreras, Emilio P. Alessandrino, Liisa Volin, Jürgen H.E. Kuball, Angela Figuera, Jorge Sierra, Jürgen Finke, Nicolaus Kröger, Theo de Witte
Haematologica October 2014 99: 1582-1590; doi:10.3324/haematol.2014.106880
Francesco Onida
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and University of Milan, Italy
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  • For correspondence: francesco.onida@unimi.it
Ronald Brand
University Medical Center, Leiden, the Netherlands
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Anja van Biezen
Chronic Malignancy WP Registry, Leiden, the Netherlands
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Michel Schaap
Radboud University - Nijmegen Medical Centre, Nijmegen, the Netherlands
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Peter A. von dem Borne
University Medical Center, Leiden, the Netherlands
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Johan Maertens
University Hospital of Leuven, Belgium
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Dietrich W. Beelen
University Hospital, Department of Bone Marrow Transplantation, Essen, Germany
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Enric Carreras
Hospital Clinic, Barcelona, Spain
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Emilio P. Alessandrino
Policlinico San Matteo, Pavia, Italy
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Liisa Volin
Helsinki University Central Hospital, Finland
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Jürgen H.E. Kuball
University Medical Centre Utrecht, the Netherlands
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Angela Figuera
Hospital de la Princesa, Madrid, Spain
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Jorge Sierra
Hospital Santa Creu I Sant Pau, Barcelona, Spain
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Jürgen Finke
Department of Medicine-Hematology, Oncology, Freiburg, Germany
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Nicolaus Kröger
University Hospital Eppendorf, Hamburg, Germany
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Theo de Witte
Radboud University - Nijmegen Medical Centre, Nijmegen, the Netherlands
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Author Affiliations

  1. Francesco Onida1⇑,
  2. Ronald Brand2,
  3. Anja van Biezen3,
  4. Michel Schaap4,
  5. Peter A. von dem Borne2,
  6. Johan Maertens5,
  7. Dietrich W. Beelen6,
  8. Enric Carreras7,
  9. Emilio P. Alessandrino8,
  10. Liisa Volin9,
  11. Jürgen H.E. Kuball10,
  12. Angela Figuera11,
  13. Jorge Sierra12,
  14. Jürgen Finke13,
  15. Nicolaus Kröger14 and
  16. Theo de Witte4
  17. for the MDS subcommittee of the EBMT-CMWP
  1. 1Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and University of Milan, Italy
  2. 2University Medical Center, Leiden, the Netherlands
  3. 3Chronic Malignancy WP Registry, Leiden, the Netherlands
  4. 4Radboud University - Nijmegen Medical Centre, Nijmegen, the Netherlands
  5. 5University Hospital of Leuven, Belgium
  6. 6University Hospital, Department of Bone Marrow Transplantation, Essen, Germany
  7. 7Hospital Clinic, Barcelona, Spain
  8. 8Policlinico San Matteo, Pavia, Italy
  9. 9Helsinki University Central Hospital, Finland
  10. 10University Medical Centre Utrecht, the Netherlands
  11. 11Hospital de la Princesa, Madrid, Spain
  12. 12Hospital Santa Creu I Sant Pau, Barcelona, Spain
  13. 13Department of Medicine-Hematology, Oncology, Freiburg, Germany
  14. 14University Hospital Eppendorf, Hamburg, Germany
  1. Correspondence: francesco.onida{at}unimi.it
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Abstract

Acquired chromosomal abnormalities are important prognostic factors in patients with myelodysplastic syndromes treated with supportive care and with disease-modifying therapeutic interventions, including allogeneic hematopoietic stem cell transplantation. To assess the prognostic impact of cytogenetic characteristics after hematopoietic stem cell transplantation accurately, we investigated a homogeneous group of 523 patients with primary myelodysplastic syndromes who have received stem cells from human leukocyte antigen-identical siblings. Overall survival at five years from transplantation in good, intermediate, and poor cytogenetic risk groups according to the International Prognostic Scoring System was 48%, 45% and 30%, respectively (P<0.01). Both the disease status (complete remission vs. not in complete remission) and the morphological classification at transplant in the untreated patients were significantly associated with probability of overall survival and relapse-free survival (P<0.01). The cytogenetic risk groups have no prognostic impact in untreated patients with refractory anemia ± ringed sideroblasts (P=0.90). However, combining the good and intermediate cytogenetic risk groups and comparing them to the poor-risk group showed within the other three disease-status-at-transplant groups a hazard ratio of 1.86 (95%CI: 1.41–2.45). In conclusion, this study shows that, in a large series of patients with primary myelodysplastic syndromes, poor-risk cytogenetics as defined by the standard International Prognostic Scoring System is associated with a relatively poor survival after allogeneic stem cell transplantation from human leukocyte antigen-identical siblings except in patients who are transplanted in refractory anemia/refractory anemia with ringed sideroblasts stage before progression to higher myelodysplastic syndrome stages.

  • Received March 5, 2014.
  • Accepted July 28, 2014.
  • Copyright© Ferrata Storti Foundation
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Vol 99 Issue 10

Haematologica: 99 (10)
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Impact of the International Prognostic Scoring System cytogenetic risk groups on the outcome of patients with primary myelodysplastic syndromes undergoing allogeneic stem cell transplantation from human leukocyte antigen-identical siblings: a retrospective analysis of the European Society for Blood and Marrow Transplantation-Chronic Malignancies Working Party
Francesco Onida, Ronald Brand, Anja van Biezen, Michel Schaap, Peter A. von dem Borne, Johan Maertens, Dietrich W. Beelen, Enric Carreras, Emilio P. Alessandrino, Liisa Volin, Jürgen H.E. Kuball, Angela Figuera, Jorge Sierra, Jürgen Finke, Nicolaus Kröger, Theo de Witte
Haematologica Oct 2014, 99 (10) 1582-1590; DOI: 10.3324/haematol.2014.106880

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Francesco Onida, Ronald Brand, Anja van Biezen, Michel Schaap, Peter A. von dem Borne, Johan Maertens, Dietrich W. Beelen, Enric Carreras, Emilio P. Alessandrino, Liisa Volin, Jürgen H.E. Kuball, Angela Figuera, Jorge Sierra, Jürgen Finke, Nicolaus Kröger, Theo de Witte
Haematologica Oct 2014, 99 (10) 1582-1590; DOI: 10.3324/haematol.2014.106880
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