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 Lee; Sung Yong Kim; Hong Ghi Lee

doi:10.1371/journal.pone.0166245

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

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 language	English
Article number	e0166245
Journal	PLoS ONE
Volume	11
Issue number	11
DOIs	https://doi.org/10.1371/journal.pone.0166245
State	Published - Nov 2016

Bibliographical note

Publisher Copyright:
© 2016 Suh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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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), Article e0166245. https://doi.org/10.1371/journal.pone.0166245

@article{fad3ba4a81c046149731808044926eef,

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

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.",

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

note = "Publisher Copyright: {\textcopyright} 2016 Suh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2016",

month = nov,

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Suh, KJ, Cheong, JW, Kim, I, Kim, HJ, Shin, DY, Koh, Y, Yoon, SS, Min, YH, Ahn, JS, Kim, YK, Lee, YG, Lee, JO, Bang, SM, Mun, YC, Seong, CM, Park, Y, Kim, BS, Hong, J, Park, J, Lee, JH, Kim, SY & Lee, HG 2016, 'Prognostic impact of IPSS-R and chromosomal translocations in 751 Korean patients with primary myelodysplastic syndrome', PLoS ONE, vol. 11, no. 11, e0166245. https://doi.org/10.1371/journal.pone.0166245

TY - JOUR

T1 - Prognostic impact of IPSS-R and chromosomal translocations in 751 Korean patients with primary myelodysplastic syndrome

AU - Suh, Koung Jin

AU - Cheong, June Won

AU - Kim, Inho

AU - Kim, Hyeoung Joon

AU - Shin, Dong Yeop

AU - Koh, Youngil

AU - Yoon, Sung Soo

AU - Min, Yoo Hong

AU - Ahn, Jae Sook

AU - Kim, Yeo Kyeoung

AU - Lee, Yun Gyoo

AU - Lee, Jeong Ok

AU - Bang, Soo Mee

AU - Mun, Yeung Chul

AU - Seong, Chu Myoung

AU - Park, Yong

AU - Kim, Byung Soo

AU - Hong, Junshik

AU - Park, Jinny

AU - Lee, Jae Hoon

AU - Kim, Sung Yong

AU - Lee, Hong Ghi

N1 - Publisher Copyright: © 2016 Suh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2016/11

Y1 - 2016/11

N2 - 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.

AB - 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.

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U2 - 10.1371/journal.pone.0166245

DO - 10.1371/journal.pone.0166245

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AN - SCOPUS:84994410149

SN - 1932-6203

VL - 11

JO - PLoS ONE

JF - PLoS ONE

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ER -

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

Abstract

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