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Srivastava VM, Nair SC, Joy M, Manipadam MT, Kulkarni UP, Devasia AJ, Fouzia NA, Korula A, Lakshmi KM, Jeyaseelan L, Abraham A, Srivastava A. Higher prevalence of poor prognostic markers at a younger age in adult patients with myelodysplastic syndrome - evaluation of a large cohort in India. Mol Cytogenet 2024; 17:21. [PMID: 39334460 PMCID: PMC11438259 DOI: 10.1186/s13039-024-00687-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/15/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The karyotype is a major determinant of prognosis in myelodysplastic syndrome (MDS). Details of the cytogenetic profile of MDS in South Asia are limited because cytogenetic services are not widely available. METHODS We performed a retrospective analysis of the cytogenetic and clinicopathologic profile of adult primary MDS seen consecutively at a tertiary-care centre in South India between 2003 and 2017. Patients were re-categorised according to the 2022 World Health Organisation (WHO) and the International Consensus classifications (ICC). RESULTS There were 936 patients aged 18-86 years (median age 53, 65% males), with MDS with del 5q, low blasts and increased blasts in 7.5%, 58.4% and 34.1% respectively. Clonal abnormalities were seen in 55% of patients, with solitary abnormalities in 29.8% and complex karyotypes (CK, ≥ 3 abnormalities) in 15%. The most frequent abnormalities were monosomy 7/deletion 7q (16.1%), deletion 5q (14.5%), trisomy 8 (11.5%), and deletion 20q (5.1%). Cytogenetic prognosis groups were distributed as follows: very good, 2%; good, 55.6%; intermediate, 16.2%; poor, 15%; very poor, 11.2%. Clinical (IPSS-R) risk stratification (842 patients) showed: very low-risk, 3.9%; low-risk, 30.9%; intermediate-risk, 24.2%; high-risk, 21%; very high-risk, 20%. Age-adjustment (IPSS-RA) raised the very low-risk group to 12.4%; the other groups decreased by 1-3% each. CONCLUSION The most significant finding of this cytogenetic analysis of MDS in India is that abnormal karyotypes with poor prognosis markers including monosomy 7 and CK were more frequent than in most other reports, among patients who were overall younger. Trisomy 8, deletion 20q, the IPSS-R intermediate-risk and both high-risk groups were more common than in the West. Trisomy 8 was less common than in South-East Asia while CK and deletion 20q were comparable. Evaluation of such large cohorts highlights the unique features of MDS in different parts of the world. These findings suggest that there could be differences in predisposing factors, environmental or genetic, and emphasise the need for further exploration to better understand the varied nature of MDS.
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Affiliation(s)
- Vivi M Srivastava
- Department of Cytogenetics, Christian Medical College, Vellore, India.
| | - Sukesh Chandran Nair
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Melvin Joy
- Department of Biostatistics, Christian Medical College, Vellore, India
- Leukaemia Research Cytogenetics Group, Centre for Cancer, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | | | - Uday P Kulkarni
- Department of Haematology, Christian Medical College, Vellore, India
| | - Anup J Devasia
- Department of Haematology, Christian Medical College, Vellore, India
| | - N A Fouzia
- Department of Haematology, Christian Medical College, Vellore, India
| | - Anu Korula
- Department of Haematology, Christian Medical College, Vellore, India
| | - Kavitha M Lakshmi
- Department of Haematology, Christian Medical College, Vellore, India
| | - L Jeyaseelan
- Department of Biostatistics, Christian Medical College, Vellore, India
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, UAE
| | - Aby Abraham
- Department of Haematology, Christian Medical College, Vellore, India
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
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Awidi A, Alzu'bi M, Odeh N, Alrawabdeh J, Al Zyoud M, Hamadneh Y, Bawa'neh H, Magableh A, Alshorman A, Al-Fararjeh F, Aladily T, Zeidan AM. Myelodysplastic Syndromes and Myelodysplastic Syndromes/Myeloproliferative Neoplasms: A Real-World Experience From a Developing Country. JCO Glob Oncol 2024; 10:e2300281. [PMID: 38422464 PMCID: PMC10914245 DOI: 10.1200/go.23.00281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/10/2023] [Accepted: 12/11/2023] [Indexed: 03/02/2024] Open
Abstract
PURPOSE Myelodysplastic syndromes (MDS) include a heterogeneous group of clonal bone marrow disorders characterized by ineffective hematopoiesis. They manifest as dysplasia in bone marrow hemopoietic elements associated with peripheral cytopenias with variable risk of AML transformation. PATIENTS AND METHODS We analyzed retrospectively registry data collected prospectively from patients with primary MDS and patients with MDS/myeloproliferative neoplasm (MPN) in the Jordan University Hospital between January 2007 and September 2021. The registry captured epidemiologic information such as date of diagnosis, age, gender, date of AML transformation, cytogenetics, MDS subtype, risk group according to Revised International Prognostic Scoring System, and survival. The registry also captured baseline ferritin, B12, and lactate dehydrogenase levels. RESULTS A total of 112 patients with MDS and MDS/MPN were included in the registry. Median age at diagnosis was 59 years. The male-to-female ratio was about 1.2. In a multivariate cox regression model, baseline serum ferritin significantly affected survival as patients with levels exceeding 1,000 μg/L had a risk of death three times higher compared with those with <1,000 μg/L levels (P < .05). CONCLUSION To our knowledge, our study is the first comprehensive study examining the epidemiology and prognostic factors in patients with MDS and patients with MDS/MPN in Jordan. Our results show that MDS and MDS/MPN epidemiology in Jordan is different compared with Western countries. Our results also show that baseline serum ferritin levels can be used as a prognostic marker for patients with MDS.
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Affiliation(s)
- Abdalla Awidi
- Medical School, University of Jordan, Amman, Jordan
- Jordan University Hospital, Amman, Jordan
- Cell Therapy Center, University of Jordan, Amman, Jordan
| | | | - Nada Odeh
- Medical School, University of Jordan, Amman, Jordan
| | | | | | | | | | | | - Alaa Alshorman
- Jordan University Hospital, Amman, Jordan
- Al-Basheer Hospital, Ministry of Health, Amman, Jordan
| | - Feras Al-Fararjeh
- Medical School, University of Jordan, Amman, Jordan
- Jordan University Hospital, Amman, Jordan
| | - Tariq Aladily
- Medical School, University of Jordan, Amman, Jordan
- Jordan University Hospital, Amman, Jordan
| | - Amer M. Zeidan
- Yale Cancer Center and Smilow Cancer Hospital, Yale University School of Medicine, New Haven, CT
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Al-Haidose A, Yassin MA, Ahmed MN, Kunhipurayil HH, Al-Harbi AA, Aljaberi MA, Abbasi SA, Kordasti S, Abdallah AM. Distinct Clinical and Prognostic Features of Myelodysplastic Syndrome in Patients from the Middle East, North Africa, and Beyond: A Systemic Review. J Clin Med 2023; 12:jcm12082832. [PMID: 37109168 PMCID: PMC10143809 DOI: 10.3390/jcm12082832] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.
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Affiliation(s)
- Amal Al-Haidose
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | - Mohamed A Yassin
- Medical Oncology Department-Hematology Section, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha 3050, Qatar
| | - Muna N Ahmed
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | - Hasna H Kunhipurayil
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | | | - Musheer A Aljaberi
- Faculty of Medicine & Health Sciences, Taiz University, Taiz 6803, Yemen
| | - Saddam A Abbasi
- Statistics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
- Statistical Consulting Unit, College of Arts and Science, Qatar University, Doha 2713, Qatar
| | - Shahram Kordasti
- School of Cancer and Pharmaceutical Science, King's College London, London WC2R 2LS, UK
- Haematology Department, Guy's and St. Thomas NHS Trust, London SE1 9RT, UK
| | - Atiyeh M Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
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LncRNA BC200/miR-150-5p/MYB positive feedback loop promotes the malignant proliferation of myelodysplastic syndrome. Cell Death Dis 2022; 13:126. [PMID: 35136029 PMCID: PMC8825806 DOI: 10.1038/s41419-022-04578-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 01/12/2022] [Accepted: 01/26/2022] [Indexed: 12/16/2022]
Abstract
Myelodysplastic syndrome (MDS) is a group of heterogeneous hematologic malignancies with a risk of transformation to acute myeloid leukemia. Understanding the molecular mechanisms of the specific roles of long noncoding RNAs (lncRNAs) in MDS would create novel ways to identify diagnostic and therapeutic targets. The lncRNA BC200 is upregulated and acts as an oncogene in various cancers; however, its expression, clinical significance, and roles in MDS remain unclear. Here, we found that BC200 was highly expressed in MDS patients compared with normal individuals. Knockdown of BC200 inhibited MDS cell proliferation, colony formation, and cell cycle progression in vitro and suppressed the growth and invasiveness of MDS cells in vivo. Mechanistic investigations revealed that BC200 functioned as a miRNA sponge to positively regulate the expression of MYB through sponging miR-150-5p and subsequently promoted malignant proliferation of MDS cells. Conversely, we found that BC200 was a direct transcriptional target of MYB, and knockdown of MYB abolished the oncogenic effect of BC200/miR-150-5p. Taken together, our results revealed that the BC200/miR-150-5p/MYB positive feedback loop promoted the proliferation of MDS cells and is expected to be a potential biomarker and therapeutic target in MDS.
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Vu MP, Ha HQ, Nguyen CN. Cytogenetic characteristics in Vietnamese patients diagnosed with primary myelodysplastic syndromes. Leuk Res Rep 2022; 18:100343. [PMID: 36032421 PMCID: PMC9411652 DOI: 10.1016/j.lrr.2022.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/13/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background The karyotype is the important factor for the diagnosis and prognosis of primary myelodysplastic syndromes (MDS). Some previous studies have suggested that the incidence of chromosomal variations in MDS was related to race. We analyze the chromosomal characteristics in Vietnamese patients with MDS to find differences compared to other races and the association with subtypes by WHO classification. Methods Sixty patients with new primary MDS diagnoses underwent cytogenetic analysis and FISH for del(5q). Results Twenty-five patients (41.67%) had an abnormal karyotype at the time of diagnosis, in which 18 patients with a complex karyotype (≥3 chromosomal abnormality) represented the highest percentage (30%). The most frequent chromosomal abnormalities were +8 found in 10/60 patients (16.7%), del (5q) in 9/60 patients (15%), -18 in 5/60 patients (8.3%), only one patient had isolated del(5q) with 1.67%. Patients with abnormal karyotype had higher odds of being MDS-EB (MDS with excess blast) compared to those with normal karyotype (OR = 3.407, 95% CI = 1.164 - 9.976). Patients with complex karyotypes had a higher probability of having MDS-EB compared to those without complex karyotype (OR = 3.25, 95% CI = 1.018 - 10.379). Conclusions The complex karyotype was the most frequent chromosomal abnormality. Patients with an abnormal or complex karyotype had a higher probability of having MDS with excess blast. The isolated del (5q) ratio is very low compared to Europe and North Africa, but similar to China and Japan as they are the same countries in East Asia.
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Affiliation(s)
- Minh Phuong Vu
- Hanoi Medical University, Department of Hematology, 1 Ton That Tung Street, Hanoi, Vietnam.,Bach Mai Hospital, Center for Hematology and Blood Transfusion, 78 Giai Phong Road, Hanoi, Vietnam
| | - Hong Quang Ha
- Bach Mai Hospital, Center for Hematology and Blood Transfusion, 78 Giai Phong Road, Hanoi, Vietnam
| | - Cuc Nhung Nguyen
- Bach Mai Hospital, Center for Hematology and Blood Transfusion, 78 Giai Phong Road, Hanoi, Vietnam
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AlMozain N, Mashi A, Alneami Q, Al-Omran A, Bakshi N, Owaidah T, Khalil S, Khogeer H, Hashmi S, Al-Sweedan S, Morris T, AlNounou R. Spectrum of myelodysplastic syndrome in patients evaluated for cytopenia(s). A Report from a Reference Centre in Saudi Arabia. Hematol Oncol Stem Cell Ther 2020; 15:39-44. [PMID: 33227261 DOI: 10.1016/j.hemonc.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/03/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/OBJECTIVE Myelodysplastic syndrome (MDS) is a clonal disorder of hematopoietic stem cells, characterized by ineffective hematopoiesis, peripheral cytopenias along with hypercellularity of the bone marrow, and marked dysplastic features. Establishing MDS diagnosis is difficult due to nonspecific clinical presentation and imprecise morphological criteria. In anticipation to improve the diagnostic approach in this field, we aimed to characterize the clinical and morphological features of patients presented with cytopenias with a special focus on MDS. METHODS We comprehensively reviewed all medical record of patients who were referred to the hematology laboratory at KFSH-RC, Riyadh, Saudi Arabia, between January 2009 and March 2016 for evaluation of bone marrow aspirates and trephine biopsies due to severe and persistent cytopenia(s) to rule out MDS. RESULTS A total of 183 patients, 155 adult and 28 pediatric, were identified. In the adult group, MDS was diagnosed in 82 (52.9%) patients, with a male-to-female (M:F) ratio of 1.6:1 and mean age at diagnosis of 50 years. According to the World Health Organization (WHO) 2017 criteria, MDS subtypes were as follows: MDS with single lineage dysplasia (SLD, 5%), MDS with ring sideroblasts and SLD (MDS-RS-SLD 7%), MDS with multilineage dysplasia (MDS-MLD 21%), MDS with deletion of chromosome 5q (MDS del(5q), 2%), MDS unclassifiable (MDS-U7%), hypoplastic MDS (h-MDS 4%), MDS with excess blasts-1 (MDS-EB1, 20%), MDS with excess blasts-2 (MDS- EB2, 28%), and therapy-related MDS (6%). Laboratory and morphological features were described. In both groups, cytogenetic abnormalities were classified according to the Revised International Prognostic Scoring System cytogenetic risk groups. In adults, the dominating cytogenetic abnormalities were monosomy 5 and monosomy 7 seen in 20.7% and 24.4% of patients, respectively. Peripheral cytopenia not due to MDS was diagnosed in 54 (34.8%) patients, with a mean age of 43 years and M:F ratio of 1:1. The cause of these cytopenias were as follows: bone marrow failure (BMF, 22%), peripheral destruction (20%), drug induced (20%), anemia of chronic disease (16%), B12 deficiency (7%), infection (7%), paroxysmal nocturnal hemoglobinuria (4%), idiopathic cytopenia of undetermined significance (2%), and idiopathic dysplasia of undetermined significance (2%). A definite diagnosis of MDS was not possible in 19 patients due to insufficient clinical data. In the pediatric group, MDS was diagnosed in 14/28 (50%) patients, with M:F ratio of 1.8:1 and mean age at diagnosis of 4 years. MDS subtypes (WHO 2017) in 14 patients were as follows: refractory cytopenia of childhood (RCC, 42.8%), MDS-EB1 (42.8%), and MDS-EB2 (14.2%). Laboratory and morphological features were described. The prevalent cytogenetic abnormality was monosomy 7 in six/14 (42.8%) patients. Cytopenias due to other causes were diagnosed in eight/28 patients (28.5%), with a mean age of 6.5 years and M:F ratio of 1.6:1. The causes of non-MDS related cytopenia were: congenital BMF (4 patients), peripheral destruction (2 patients), immune deficiency (1 patient), and viral infection (1 patient). A definite diagnosis of MDS could not be made in six/28 (21.4%) patients. CONCLUSION MDS is the cause of cytopenia in a significant number of patients referred for evaluation of cytopenias, appears at younger age, and tends to be more aggressive than that reported in international studies. Anemia, dysplastic neutrophils in the peripheral blood, and dysplastic megakaryocytes in the bone marrow trephine biopsy are the most reliable features in distinguishing MDS from other alternative diagnoses.
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Affiliation(s)
- Nour AlMozain
- Department of the Blood Bank, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Ayman Mashi
- Department of Laboratory and Bloo Bank, King Fahad Central Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Qasem Alneami
- Department of Laboratory and Bloo Bank, King Fahad Central Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Amal Al-Omran
- Medical student, King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Nasir Bakshi
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Tarek Owaidah
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Salem Khalil
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Haitham Khogeer
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Shahrukh Hashmi
- Department of Medicine, Sheikh Shakbout Medical City, Abu Dhabi, United Arab Emirates
| | - Suleimman Al-Sweedan
- Department of Pediatrics, Jordan University of Science and Technology, Irbid, Jordan.
| | - Thomas Morris
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Randa AlNounou
- Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Kaniyattu SM, Meenakshi A, Kumar MB, Kumar KR, Rao S, Shetty PD, Shetty V, Shetty JK, Shetty PK. Cytogenetic and cytokine profile in elderly patients with cytopenia. Exp Hematol 2020; 89:80-86. [PMID: 32739457 DOI: 10.1016/j.exphem.2020.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
In the elderly with cytopenia, the diagnosis of myelodysplastic syndrome (MDS) may be missed. Cytokine levels contribute to the pathology of MDS. Hence, the objectives were to evaluate cytogenetic profile as a prognostic indicator in risk stratification and cytokine levels as a screening tool in patients with cytopenia for diagnosis. Over 2 years (2016-2018), 150 elderly patients were screened. MDS diagnosis was confirmed by morphology. Interleukin-2 (IL-2) and IL-6 levels were assessed in 50 patients, and karyotyping was performed in 20 confirmed cases of MDS. Age-matched healthy controls were used for comparison of cytokine levels. Among 150 patients, 88.6% had anemia, including nutritional anemia (51.2%). MDS diagnosis was confirmed in 35 patients. In 15 patients, unexplained cytopenia (UC) was present. Karyotyping in 20 MDS patients was normal in 15 (75%) patients and revealed a complex karyotype in four (20%) patients and double chromosomal abnormality in one (5%) patient. The Revised International Prognostic Scoring System (IPSS-R) scored 91% in the low-risk group and 9% (n = 3) in the high-risk group; the latter three developed acute myeloid leukemia (AML) and two of them had a 7q deletion. Among the 15 cases of UC, one patient died from refractory anemia. No significant difference in levels of IL-2 and IL-6 were found between MDS and UC patients when compared with healthy controls, as well as between different risk groups and karyotypes. A significant difference in IL-2 levels was found in MDS patients with disease progression and with stable disease. On the basis of the findings, it is suggested that IL-2 levels will help in predicting disease progression.
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Affiliation(s)
| | - Arumugam Meenakshi
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | - Mohana B Kumar
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | | | - Shama Rao
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | - Prashanth D Shetty
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | - Vijith Shetty
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | - Jayaprakash K Shetty
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India
| | - Padma K Shetty
- K. S. Hegde Medical Academy, Nitte (Deemed to Be University), Deralakatte, Mangaluru, India.
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Phrommin S, Tantiworawit A, Rattanathammethee T, Puaninta C, Pangjaidee N, Aungsuchawan S, Bumroongkit K. Chromosomal Abnormalities in Myelodysplastic Syndrome Patients in Upper Northern Thailand. Asian Pac J Cancer Prev 2020; 21:639-645. [PMID: 32212788 PMCID: PMC7437337 DOI: 10.31557/apjcp.2020.21.3.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Indexed: 12/01/2022] Open
Abstract
Objective: Chromosome detection is important in the diagnosis and prognosis of Myelodysplastic syndrome (MDS) patients. About 50% of MDS patients have chromosomal abnormalities. Moreover, chromosome 5 and 7 are common genetic abnormalities in MDS patients and use to identify prognosis risk group and the proper treatment in MDS patients. The objective of this study was to evaluate chromosomal abnormalities and clinical features of MDS patients in upper northern Thailand. Methods: Fifty bone marrow (BM) specimens were examined by conventional cytogenetic (CC) technique and fluorescence in situ hybridization (FISH) technique for detected chromosome 5 and 7 abnormalities. The clinical features were comparison between MDS patients with chromosomal abnormalities and those with normal karyotype. Results: Chromosomal abnormalities were detected in 8/50 MDS patients by CC and 17/50 cases by FISH technique. When the CC and FISH techniques were combined, chromosomal abnormalities increased to 21/50 cases. Abnormalities of isolated chromosome 5 were found in 13 cases and were associated with lower level of percentage blast of BM (p = 0.003) and higher level of hemoglobin (p = 0.019). Moreover, abnormalities of chromosome 7 were found in 3 cases, 1 case of isolated del(7q) and 2 cases of -7 and del(7q) with complex abnormalities. These three cases were associated with higher level of percentage blast of BM (p = 0.010). Conclusion: This study showed the frequency and pattern of chromosomal abnormalities of MDS patients in upper northern Thailand were different from other populations. MDS with isolated chromosome 5 abnormalities had clinical characteristics corresponding with patients in good prognosis risk group. However, MDS patients with chromosome 7 and complex abnormalities showed higher percentage blast of BM which high risk to progression to acute myeloid leukemia (AML). Combined CC and FISH techniques detect chromosomal abnormalities with greater frequency than when either technique is used alone.
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Affiliation(s)
- Suphitcha Phrommin
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanawat Rattanathammethee
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaniporn Puaninta
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nathaporn Pangjaidee
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirinda Aungsuchawan
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokkan Bumroongkit
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Mohammad AA. Myelodysplastic syndrome from theoretical review to clinical application view. Oncol Rev 2018; 12:397. [PMID: 30607219 PMCID: PMC6291758 DOI: 10.4081/oncol.2018.397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/15/2018] [Indexed: 02/06/2023] Open
Abstract
Myelodysplastic syndromes (MDS), called ineffective hematopoiesis is indicated by bone marrow failure and tendency to acute myeloid leukemia transformation. Since the disease is more common in elderly with non- hematology co-morbidities, the research for less toxic and curative novel agents is essential. More than 12 years without new Food and Drug Administration approved drugs in MDS management through the whole course, only 5 drugs. We summarized the basic data in diagnosis, treatment guidelines and future direction.
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Affiliation(s)
- Amrallah A. Mohammad
- Medical Oncology, Department of Medical Oncology, Faculty of Medicine, Zagazig University, Egypt
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