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Blood, 15 December 2007, Vol. 110, No. 13, pp. 4385-4395. Prepublished online as a Blood First Edition Paper on August 28, 2007; DOI 10.1182/blood-2007-03-082404.
Submitted March 29, 2007
Department of Hematology and Oncology, University of Gottingen, Gottingen, Germany * Corresponding author; email: haase.onkologie{at}med.uni-goettingen.de.
We have generated a large, unique database that includes morphologic, cytogenetic, and follow-up data from 2124 patients with MDS at 4 institutions in Austria and 4 in Germany. Cytogenetic analyses were successfully performed in 2072 patients (97.6%), revealing clonal abnormalities in 1084 (52.3%). Numerical and structural chromosomal abnormalities were documented for each patient and subdivided further according to the number of additional abnormalities. The impact of the karyotype on the natural course of the disease was studied in 1286 patients treated with supportive care only. Median survival was 53.4 months for patients with normal karyotypes (n = 612) and 8.7 months for those with complex anomalies (n = 166). Thirteen rare abnormalities were identified with good [+1/+1q, t(1q), t(7q), 9q-, 12p-, chromosome 15 anomalies, t(17q), monosomy 21, trisomy 21, –X], intermediate (11q-, chromosome 19 anomalies), or poor [t(5q)] prognostic impact, respectively. For all World Health Organization (WHO) and French-American-British (FAB) classification system subtypes, the karyotype provided additional prognostic information. Our analyses offer new insights into the prognostic significance of rare chromosomal abnormalities and specific karyotypic combinations in MDS.
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