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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.
Previous Article | Next Article 
Submitted March 29, 2007
Accepted July 19, 2007
New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients
Detlef Haase*, Ulrich Germing, Julie Schanz, Michael Pfeilstocker, Thomas Nosslinger, Barbara Hildebrandt, Andrea Kundgen, Michael Lubbert, Regina Kunzmann, Aristoteles A.N. Giagounidis, Carlo Aul, Lorenz Trumper, Otto Krieger, Reinhard Stauder, Thomas H. Muller, Friedrich Wimazal, Peter Valent, Christa Fonatsch, and Christian Steidl
Department of Hematology and Oncology, University of Gottingen, Gottingen, Germany
Department of Hematology and Oncology, University of Dusseldorf, Dusseldorf, Germany
3rd Medical Department for Hematology and Oncology, and L. Boltzmann Institute for Leukemia Research and Hematology, Hanusch Hospital, Vienna, Austria
Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
Department of Hematology and Oncology, Johannes Hospital, Duisburg, Germany
Department of Hematology and Oncology, Elisabethinen Hospital, Linz, Austria
Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
Institute of Biostatistics, University of Munich, Munich, Germany
Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
* 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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