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Fonatsch C, Miller K, Schwinger E. Nachruf Gebhard Flatz (1925–2019). MED GENET-BERLIN 2020. [DOI: 10.1515/medgen-2020-2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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2
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Schanz J, Solé F, Mallo M, Luño E, Cervera J, Granada I, Hildebrandt B, Slovak ML, Ohyashiki K, Fonatsch C, Pfeilstöcker M, Nösslinger T, Valent P, Giagounidis A, Aul C, Lübbert M, Stauder R, Krieger O, Le Beau MM, Bennett JM, Greenberg P, Germing U, Haase D. Clonal architecture in patients with myelodysplastic syndromes and double or minor complex abnormalities: Detailed analysis of clonal composition, involved abnormalities, and prognostic significance. Genes Chromosomes Cancer 2018; 57:547-556. [PMID: 30248204 DOI: 10.1002/gcc.22667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 11/12/2022] Open
Abstract
The study analyzes the clonal architecture and the abnormalities involved in a series of 191 patients with myelodysplastic syndromes (MDS) and 2-3 clonal abnormalities. All patients were extracted from an international database. The patients were classified into six clonal subtypes (2A-3C) based on the number of abnormalities and the presentation of unrelated clones (UC) and/or a clonal evolution. UC were detected in 23/191 patients (12%). The composition of UC showed great variability. The only recurrent combination of abnormalities was del(5q) and + 8 in 8 of 23 patients (35%). In patients with clonal evolution, the clone size of the primary and secondary clone varied: Patients with -7 and + 8 in the primary clone showed a larger primary and a smaller secondary clone (-7: median 74% vs 10%; +8 73% vs 18%) while patients with del(5q) in the primary clone showed a smaller primary and a larger secondary clone (33% vs 61%). Univariate and multivariate analyses showed no significant differences regarding overall or AML-free survival between the clonal subtypes. Only the subtype 3C (3 abnormalities and clonal evolution) was an independent risk factor for developing AML (Hazard Ratio 5.5 as compared to subtype 2A, P < .05). Finally, our study confirms that the number of abnormalities clearly defines a significant risk factor for overall- as well as AML-free survival. Importantly, in patients with more than one clone, the calculation of the number of abnormalities in the entire sample instead of the number of abnormalities per clone allows a higher prognostic accuracy.
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Affiliation(s)
- Julie Schanz
- Department of Hematology and Medical Oncology, University of Göttingen, Göttingen, Germany
| | - Francesc Solé
- Institut de Recerca contra la Leucèmia Josep Carreras (IJC), ICO-Hospital Germans Trias i Pujol, Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Mar Mallo
- Institut de Recerca contra la Leucèmia Josep Carreras (IJC), ICO-Hospital Germans Trias i Pujol, Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Elisa Luño
- Department of Hematology, Central University Hospital of Asturias, Oviedo, Spain
| | - Jose Cervera
- Department of Hematology, Hospital La Fe, Valencia, Spain
| | - Isabel Granada
- Department of Hematology, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Barbara Hildebrandt
- Department of Human Genetics, University of Duesseldorf, Duesseldorf, Germany
| | - Marylin L Slovak
- University of New Mexico/TriCore Reference Laboratories, Cytogenetics Laboratory, Albuquerque, New Mexico
| | - Kazuma Ohyashiki
- First Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
| | - Christa Fonatsch
- Department of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Michael Pfeilstöcker
- 3rd Medical department, Hanusch Hospital, L. Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - Thomas Nösslinger
- 3rd Medical department, Hanusch Hospital, L. Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - Peter Valent
- Department of Medicine I, Division of Hematology, Medical University of Vienna, Vienna, Austria
| | | | - Carlo Aul
- Department of Hematology and Oncology, Johannes Hospital, Duisburg, Germany
| | - Michael Lübbert
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - Reinhard Stauder
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Otto Krieger
- Department of Internal Medicine I, Elisabethinen Hospital, Linz, Austria
| | | | - John M Bennett
- Department of Medicine, Hematology/Oncology, University of Rochester, Medical Center, Rochester, New York
| | - Peter Greenberg
- Division of Hematology, Stanford University Cancer Center, Stanford, California
| | - Ulrich Germing
- Department of Hematology, University of Duesseldorf, Oncology and Clinical Immunology, Düsseldorf, Germany
| | - Detlef Haase
- Department of Hematology and Medical Oncology, University of Göttingen, Göttingen, Germany
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Miyazaki Y, Tuechler H, Sanz G, Schanz J, Garcia-Manero G, Solé F, Bennett JM, Bowen D, Fenaux P, Dreyfus F, Kantarjian H, Kuendgen A, Malcovati L, Cazzola M, Cermak J, Fonatsch C, Le Beau MM, Slovak ML, Santini V, Lübbert M, Maciejewski J, Machherndl-Spandl S, Magalhaes SMM, Pfeilstöcker M, Sekeres MA, Sperr WR, Stauder R, Tauro S, Valent P, Vallespi T, van de Loosdrecht AA, Germing U, Haase D, Greenberg PL. Differing clinical features between Japanese and Caucasian patients with myelodysplastic syndromes: Analysis from the International Working Group for Prognosis of MDS. Leuk Res 2018; 73:51-57. [PMID: 30219650 DOI: 10.1016/j.leukres.2018.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/07/2018] [Accepted: 08/31/2018] [Indexed: 01/12/2023]
Abstract
Clinical features of myelodysplastic syndromes (MDS) could be influenced by many factors, such as disease intrinsic factors (e.g., morphologic, cytogenetic, molecular), extrinsic factors (e.g, management, environment), and ethnicity. Several previous studies have suggested such differences between Asian and European/USA countries. In this study, to elucidate potential differences in primary untreated MDS between Japanese (JPN) and Caucasians (CAUC), we analyzed the data from a large international database collected by the International Working Group for Prognosis of MDS (300 and 5838 patients, respectively). JPN MDS were significantly younger with more severe cytopenias, and cytogenetic differences: less del(5q) and more +1/+1q, -1/del(1p), der(1;7), -9/del(9q), del(16q), and del(20q). Although differences in time to acute myeloid leukemia transformation did not occur, a significantly better survival in JPN was demonstrated, even after the adjustment for age and FAB subtypes, especially in lower, but not in higher prognostic risk categories. Certain clinical factors (cytopenias, blast percentage, cytogenetic risk) had different impact on survival and time to transformation to leukemia between the two groups. Although possible confounding events (e.g., environment, diet, and access to care) could not be excluded, our results indicated the existence of clinically relevant ethnic differences regarding survival in MDS between JPN and CAUC patients. The good performance of the IPSS-R in both CAUC and JP patients underlines that its common risk model is adequate for CAUC and JP.
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Affiliation(s)
- Yasushi Miyazaki
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Heinz Tuechler
- L. Boltzmann Institute for Leukemia Research, Vienna, Austria
| | | | - Julie Schanz
- University Medical Center, Clinics of Haematology and Medical Oncology, Göttingen, Germany
| | | | - Francesc Solé
- Institut de Recerca contra la Leucèmia Josep Carreras, Barcelona, Spain
| | - John M Bennett
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, United States
| | - David Bowen
- St James's University Hospital, Leeds, United Kingdom
| | - Pierre Fenaux
- Hopital Avicenne, Assistance Publique-Hopitaux de Paris (AP-HP)/University of Paris XIII, Bobigny, France
| | | | - Hagop Kantarjian
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Luca Malcovati
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Mario Cazzola
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Jaroslav Cermak
- Institute of Hematology and Blood Transfusion, Praha, Czech Republic
| | | | - Michelle M Le Beau
- University of Chicago Comprehensive Cancer Research Center, Chicago, IL, United States
| | - Marilyn L Slovak
- Department of Pathology, University of New Mexico, Albuquerque, NM, United States
| | - Valeria Santini
- MDS Unit, Ematologia, AOU Careggi, Università degli Studi di Firenze, Firenze, Italy
| | - Michael Lübbert
- University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany
| | | | | | | | | | | | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Austria
| | | | | | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Austria
| | | | | | | | - Detlef Haase
- University Medical Center, Clinics of Haematology and Medical Oncology, Göttingen, Germany
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Schanz J, Cevik N, Fonatsch C, Braulke F, Shirneshan K, Bacher U, Haase D. Detailed analysis of clonal evolution and cytogenetic evolution patterns in patients with myelodysplastic syndromes (MDS) and related myeloid disorders. Blood Cancer J 2018. [PMID: 29515104 PMCID: PMC5841340 DOI: 10.1038/s41408-018-0061-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Clonal cytogenetic evolution (CE) (i.e., acquisition of new chromosomal aberrations over time) is relevant for the progression of myelodysplastic syndromes (MDS). We performed detailed analysis of CE in 729 patients with MDS and related disorders. Patients with CE showed shorter survival (median OS 18.0 versus 53.9 months; P < 0.01), higher leukemic transformation rate (48.0% versus 21.4%; P < 0.01) and shorter intervals to leukemic transformation (P < 0.01). Two main CE patterns were detected: early versus late CE (median onset 5.3 versus 21.9 months; P < 0.01) with worse survival outcomes for early CE. In the case of CE, del (7q)/−7 (P = 0.020) and del (17p) (P = 0.002) were especially unfavorable. Extending the evolution patterns from Tricot et al. (1985) forming five subgroups, prognosis was best (median OS not reached) in patients with “transient clones/changing clone size”, whereas those with “CE at diagnosis” showed very poor outcomes (P < 0.01 for comparison of all). Detailed sequential cytogenetic analysis during follow-up improves prognostication in MDS patients and acknowledges the dynamic biology of the disease. Evidence, time-point, and patterns of cytogenetic clonal evolution should be included into future prognostic scoring systems for MDS.
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Affiliation(s)
- Julie Schanz
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany.
| | - Naciye Cevik
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany.,Department of Dermatology, University Medicine Göttingen (UMG), Göttingen, Germany
| | | | - Friederike Braulke
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Katayoon Shirneshan
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Ulrike Bacher
- Department of Hematology and Central Laboratory, Inselspital Bern, Bern, Switzerland
| | - Detlef Haase
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
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Braulke F, Müller-Thomas C, Götze K, Platzbecker U, Germing U, Hofmann WK, Giagounidis AAN, Lübbert M, Greenberg PL, Bennett JM, Solé F, Slovak ML, Ohyashiki K, Le Beau MM, Tüchler H, Pfeilstöcker M, Hildebrandt B, Aul C, Stauder R, Valent P, Fonatsch C, Bacher U, Trümper L, Haase D, Schanz J. Frequency of del(12p) is commonly underestimated in myelodysplastic syndromes: Results from a German diagnostic study in comparison with an international control group. Genes Chromosomes Cancer 2015; 54:809-17. [PMID: 26355708 DOI: 10.1002/gcc.22292] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/03/2015] [Accepted: 07/13/2015] [Indexed: 01/11/2023] Open
Abstract
In myelodysplastic syndromes (MDS), deletion of the short arm of chromosome 12 (del(12p)) is usually a small abnormality, rarely detected as a single aberration by chromosome banding analysis (CBA) of bone marrow metaphases. Del(12p) has been described in 0.6 to 5% of MDS patients at initial diagnosis and is associated with a good to intermediate prognosis as a sole anomaly according to current scoring systems. Here, we present the results of a systematic del(12p) testing in a German prospective diagnostic study (clinicaltrials.gov: NCT01355913) on 367 MDS patients in whom CD34+ peripheral blood cells were analysed for the presence of del(12p) by sequential fluorescence in situ hybridization (FISH) analyses. A cohort of 2,902 previously published MDS patients diagnosed by CBA served as control. We demonstrate that, using a sensitive FISH technique, 12p deletion occurs significantly more frequently in MDS than previously described (7.6% by CD34+ PB-FISH vs. 1.6% by CBA, P < 0.001) and is often associated with other aberrations (93% by CD34+ PB-FISH vs. 60% by CBA). Additionally, the detection rate can be increased by repeated analyses in a patient over time which is important for the patient´s prognosis to distinguish a sole anomaly from double or complex aberrations. To our knowledge, this is the first study to screen for 12p deletions with a suitable probe for ETV6/TEL in 12p13. Our data suggest that the supplement of a probe for the detection of a 12p deletion to common FISH probe panels helps to avoid missing a del(12p), especially as part of more complex aberrations.
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Affiliation(s)
- Friederike Braulke
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | | | - Katharina Götze
- Department of Hematology and Oncology, Technical University of Munich, Germany
| | - Uwe Platzbecker
- Department of Hematology and Oncology, University of Dresden, Germany
| | - Ulrich Germing
- Department of Hematology and Oncology, University of Duesseldorf, Germany
| | | | | | - Michael Lübbert
- Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Peter L Greenberg
- Department of Hematology, Stanford University Cancer Center, Stanford, CA
| | | | - Francesc Solé
- Institut De Recerca Contra La Leukemia Josep Carreras, Badalona, Spain
| | | | | | | | - Heinz Tüchler
- Hanusch Hospital Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - Michael Pfeilstöcker
- Third Medical Department for Hematology and Oncology and L. Boltzmann Cluster Oncology, Hanusch Hospital, Vienna, Austria
| | | | - Carlo Aul
- Department of Hematology, Oncology and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany
| | - Reinhard Stauder
- Department of Internal Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology and Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Vienna, Austria
| | - Christa Fonatsch
- Department of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Ulrike Bacher
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Lorenz Trümper
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Detlef Haase
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Julie Schanz
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
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6
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Della Porta MG, Tuechler H, Malcovati L, Schanz J, Sanz G, Garcia-Manero G, Solé F, Bennett JM, Bowen D, Fenaux P, Dreyfus F, Kantarjian H, Kuendgen A, Levis A, Cermak J, Fonatsch C, Le Beau MM, Slovak ML, Krieger O, Luebbert M, Maciejewski J, Magalhaes SMM, Miyazaki Y, Pfeilstöcker M, Sekeres MA, Sperr WR, Stauder R, Tauro S, Valent P, Vallespi T, van de Loosdrecht AA, Germing U, Haase D, Greenberg PL, Cazzola M. Validation of WHO classification-based Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodysplasia (IWG-PM). Leukemia 2015; 29:1502-13. [PMID: 25721895 DOI: 10.1038/leu.2015.55] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 02/10/2015] [Accepted: 02/16/2015] [Indexed: 02/03/2023]
Abstract
A risk-adapted treatment strategy is mandatory for myelodysplastic syndromes (MDS). We refined the World Health Organization (WHO)-classification-based Prognostic Scoring System (WPSS) by determining the impact of the newer clinical and cytogenetic features, and we compared its prognostic power to that of the revised International Prognostic Scoring System (IPSS-R). A population of 5326 untreated MDS was considered. We analyzed single WPSS parameters and confirmed that the WHO classification and severe anemia provide important prognostic information in MDS. A strong correlation was found between the WPSS including the new cytogenetic risk stratification and WPSS adopting original criteria. We then compared WPSS with the IPSS-R prognostic system. A highly significant correlation was found between the WPSS and IPSS-R risk classifications. Discrepancies did occur among lower-risk patients in whom the number of dysplastic hematopoietic lineages as assessed by morphology did not reflect the severity of peripheral blood cytopenias and/or increased marrow blast count. Moreover, severe anemia has higher prognostic weight in the WPSS versus IPSS-R model. Overall, both systems well represent the prognostic risk of MDS patients defined by WHO morphologic criteria. This study provides relevant in formation for the implementation of risk-adapted strategies in MDS.
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Affiliation(s)
- M G Della Porta
- 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - H Tuechler
- Hanusch Hospital, Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - L Malcovati
- 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - J Schanz
- Georg August Universität, Göttingen, Germany
| | - G Sanz
- Hospital Universitario La Fe, Valencia, Spain
| | - G Garcia-Manero
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - F Solé
- Institut de Recerca contra la Leucèmia Josep Carreras, Barcelona, Spain
| | - J M Bennett
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - D Bowen
- St James's University Hospital, Leeds, UK
| | - P Fenaux
- Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP)/University Paris XIII, Bobigny, France
| | - F Dreyfus
- Hôpital Cochin, AP-HP University of Paris V, Paris, France
| | - H Kantarjian
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - A Kuendgen
- Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - A Levis
- Fondazione Italiana Sindromi Mielodisplastiche c/o SS Antonio e Biagio Hospital, Alessandria, Italy
| | - J Cermak
- Institute of Hematology and Blood Transfusion, Praha, Czech Republic
| | - C Fonatsch
- Medical University of Vienna, Vienna, Austria
| | - M M Le Beau
- University of Chicago Comprehensive Cancer Research Center, Chicago, IL, USA
| | - M L Slovak
- Quest Diagnostics Nichols Institute, Chantilly, VA, USA
| | - O Krieger
- Elisabethinen Hospital, Linz, Austria
| | - M Luebbert
- University of Freiburg Medical Center, Freiburg, Germany
| | | | | | - Y Miyazaki
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Pfeilstöcker
- Hanusch Hospital and L. Boltzmann Cluster Oncology, Vienna, Austria
| | | | - W R Sperr
- Medical University of Vienna, Vienna, Austria
| | - R Stauder
- Hanusch Hospital and L. Boltzmann Cluster Oncology, Vienna, Austria
| | - S Tauro
- University of Dundee, Dundee, Scotland, UK
| | - P Valent
- Medical University of Vienna, Vienna, Austria
| | - T Vallespi
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - U Germing
- Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - D Haase
- Georg August Universität, Göttingen, Germany
| | - P L Greenberg
- Division of Hematology, Stanford University Cancer Center, Stanford, CA, USA
| | - M Cazzola
- 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Braulke F, Platzbecker U, Müller-Thomas C, Götze K, Germing U, Brümmendorf TH, Nolte F, Hofmann WK, Giagounidis AAN, Lübbert M, Greenberg PL, Bennett JM, Solé F, Mallo M, Slovak ML, Ohyashiki K, Le Beau MM, Tüchler H, Pfeilstöcker M, Nösslinger T, Hildebrandt B, Shirneshan K, Aul C, Stauder R, Sperr WR, Valent P, Fonatsch C, Trümper L, Haase D, Schanz J. Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group. Haematologica 2014; 100:205-13. [PMID: 25344522 DOI: 10.3324/haematol.2014.110452] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%-20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34(+)) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34(+) peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34(+) blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913).
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Affiliation(s)
- Friederike Braulke
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Uwe Platzbecker
- Department of Hematology and Oncology, University of Dresden, Germany
| | | | - Katharina Götze
- Department of Hematology and Oncology, Technical University of Munich, Germany
| | - Ulrich Germing
- Department of Hematology and Oncology, University of Duesseldorf, Germany
| | - Tim H Brümmendorf
- Department of Hematology and Oncology, Uniklinik, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany
| | - Florian Nolte
- Department of Hematology and Oncology, University Hospital of Mannheim, Germany
| | | | | | - Michael Lübbert
- Department of Hematology and Oncology, University of Freiburg Medical Center, Germany
| | - Peter L Greenberg
- Department of Hematology, Stanford University Cancer Center, CA, USA
| | | | - Francesc Solé
- Institut de Recerca Contra la Leucemia Josep Carreras, Badalona, Spain
| | - Mar Mallo
- Institut de Recerca Contra la Leucemia Josep Carreras, Badalona, Spain
| | | | | | | | - Heinz Tüchler
- Hanusch Hospital, Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - Michael Pfeilstöcker
- Third Medical Department for Hematology and Oncology and L. Boltzmann Institute for Leukemia Research and Hematology, Hanusch Hospital, Vienna, Austria
| | - Thomas Nösslinger
- Third Medical Department for Hematology and Oncology and L. Boltzmann Institute for Leukemia Research and Hematology, Hanusch Hospital, Vienna, Austria
| | | | - Katayoon Shirneshan
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Carlo Aul
- Department of Hematology, Oncology, and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany
| | - Reinhard Stauder
- Department of Internal Medicine, Innsbruck Medical University, Austria
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Austria
| | - Christa Fonatsch
- Department of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Lorenz Trümper
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Detlef Haase
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
| | - Julie Schanz
- Department of Hematology and Medical Oncology, University Medicine of Goettingen, Germany
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Schanz J, Tüchler H, Solé F, Mallo M, Luño E, Cervera J, Grau J, Hildebrandt B, Slovak ML, Ohyashiki K, Steidl C, Fonatsch C, Pfeilstöcker M, Nösslinger T, Valent P, Giagounidis A, Aul C, Lübbert M, Stauder R, Krieger O, Le Beau MM, Bennett JM, Greenberg P, Germing U, Haase D. Monosomal karyotype in MDS: explaining the poor prognosis? Leukemia 2013; 27:1988-95. [PMID: 23787396 DOI: 10.1038/leu.2013.187] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/30/2013] [Accepted: 06/04/2013] [Indexed: 11/09/2022]
Abstract
Monosomal karyotype (MK) is associated with an adverse prognosis in patients in acute myeloid leukemia (AML). This study analyzes the prognostic impact of MK in a cohort of primary, untreated patients with myelodysplastic syndromes (MDS). A total of 431 patients were extracted from an international database. To analyze whether MK is an independent prognostic marker in MDS, cytogenetic and clinical data were explored in uni- and multivariate models regarding overall survival (OS) as well as AML-free survival. In all, 204/431 (47.3%) patients with MK were identified. Regarding OS, MK was prognostically significant in patients with ≤ 4 abnormalities only. In highly complex karyotypes (≥ 5 abnormalities), MK did not separate prognostic subgroups (median OS 4.9 months in MK+ vs 5.6 months in patients without MK, P=0.832). Based on the number of abnormalities, MK-positive karyotypes (MK+) split into different prognostic subgroups (MK+ and 2 abnormalities: OS 13.4 months, MK+ and 3 abnormalities: 8.0 months, MK+ and 4 abnormalities: 7.9 months and MK+ and ≥ 5 abnormalities: 4.9 months; P<0.01). In multivariate analyses, MK was not an independent prognostic factor. Our data support the hypothesis that a high number of complex abnormalities, associated with an instable clone, define the subgroup with the worst prognosis in MDS, independent of MK.
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Affiliation(s)
- J Schanz
- Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany
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9
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Sekeres M, Ades L, Tuechler H, Sanz G, Levis A, Malcovati L, Cazzola M, Magalhães S, Luebbert M, Haase D, Schanz J, Cermak J, Garcia-Manero G, Sole F, Benett J, Bowen D, Dreyfus F, Kantarjian H, Kuendgen A, Fonatsch C, Le Beau M, Slovak M, Krieger O, Maciejewski J, Miyazaki Y, Pfeilstoecker M, Sperr W, Stauder R, Tauro S, Valent P, Vallespi T, Van de Loosdrecht A, Germing U, Fenaux P, Greenberg P. P-113 Revised International Prognostic Scoring System (IPSS-R) for primary treated myelodysplastic syndromes (MDS) patients: A report from the IWG-PM. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70161-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Schanz J, Tüchler H, Solé F, Mallo M, Luño E, Cervera J, Granada I, Hildebrandt B, Slovak ML, Ohyashiki K, Steidl C, Fonatsch C, Pfeilstöcker M, Nösslinger T, Valent P, Giagounidis A, Aul C, Lübbert M, Stauder R, Krieger O, Garcia-Manero G, Faderl S, Pierce S, Le Beau MM, Bennett JM, Greenberg P, Germing U, Haase D. New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge. J Clin Oncol 2012; 30:820-9. [PMID: 22331955 PMCID: PMC4874200 DOI: 10.1200/jco.2011.35.6394] [Citation(s) in RCA: 473] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 12/05/2011] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The karyotype is a strong independent prognostic factor in myelodysplastic syndromes (MDS). Since the implementation of the International Prognostic Scoring System (IPSS) in 1997, knowledge concerning the prognostic impact of abnormalities has increased substantially. The present study proposes a new and comprehensive cytogenetic scoring system based on an international data collection of 2,902 patients. PATIENTS AND METHODS Patients were included from the German-Austrian MDS Study Group (n = 1,193), the International MDS Risk Analysis Workshop (n = 816), the Spanish Hematological Cytogenetics Working Group (n = 849), and the International Working Group on MDS Cytogenetics (n = 44) databases. Patients with primary MDS and oligoblastic acute myeloid leukemia (AML) after MDS treated with supportive care only were evaluated for overall survival (OS) and AML evolution. Internal validation by bootstrap analysis and external validation in an independent patient cohort were performed to confirm the results. RESULTS In total, 19 cytogenetic categories were defined, providing clear prognostic classification in 91% of all patients. The abnormalities were classified into five prognostic subgroups (P < .001): very good (median OS, 61 months; hazard ratio [HR], 0.5; n = 81); good (49 months; HR, 1.0 [reference category]; n = 1,809); intermediate (26 months; HR, 1.6; n = 529); poor (16 months; HR, 2.6; n = 148); and very poor (6 months; HR, 4.2; n = 187). The internal and external validations confirmed the results of the score. CONCLUSION In conclusion, these data should contribute to the ongoing efforts to update the IPSS by refining the cytogenetic risk categories.
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Affiliation(s)
- Julie Schanz
- Author affiliations appear at the end of this article
| | - Heinz Tüchler
- Author affiliations appear at the end of this article
| | - Francesc Solé
- Author affiliations appear at the end of this article
| | - Mar Mallo
- Author affiliations appear at the end of this article
| | - Elisa Luño
- Author affiliations appear at the end of this article
| | - José Cervera
- Author affiliations appear at the end of this article
| | | | | | | | | | | | | | | | | | - Peter Valent
- Author affiliations appear at the end of this article
| | | | - Carlo Aul
- Author affiliations appear at the end of this article
| | | | | | - Otto Krieger
- Author affiliations appear at the end of this article
| | | | - Stefan Faderl
- Author affiliations appear at the end of this article
| | - Sherry Pierce
- Author affiliations appear at the end of this article
| | | | | | | | | | - Detlef Haase
- Author affiliations appear at the end of this article
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11
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Gruber M, Fleiss K, Porpaczy E, Skrabs C, Hauswirth AW, Gaiger A, Vanura K, Heintel D, Shehata M, Einberger C, Thalhammer R, Fonatsch C, Jäger U. Prolonged progression-free survival in patients with chronic lymphocytic leukemia receiving granulocyte colony-stimulating factor during treatment with fludarabine, cyclophosphamide, and rituximab. Ann Hematol 2011; 90:1131-6. [PMID: 21617923 DOI: 10.1007/s00277-011-1260-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 05/16/2011] [Indexed: 11/25/2022]
Abstract
The clinical benefit of the addition of granulocyte colony-stimulating factor (G-CSF) to standard immunochemotherapy of chronic lymphocytic leukemia (CLL) with fludarabine, cyclophosphamide, and rituximab (FCR) is still unclear. In this retrospective study we analyzed the outcome of 32 consecutive patients with CLL during treatment with FCR. Sixteen patients received G-CSF for treatment of CTC grade 3 or 4 neutropenia or febrile neutropenia at some point during therapy and 16 did not. Both groups were well balanced for clinical and biological risk factors. Overall response rates were not significantly different (94% vs. 75%; p=0.144). Interestingly, a significantly better progression-free survival (100% vs. 35.4% at 24 months; p<0.001) and even overall survival (100% vs. 77.8% at 24 months; p=0.022) was observed in patients receiving G-CSF. While the underlying cause remains to be elucidated, these data strongly suggest an association of the addition of G-CSF to FCR therapy with final patient outcome.
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MESH Headings
- Aged
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cohort Studies
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cyclophosphamide/therapeutic use
- Drug Monitoring
- Female
- Granulocyte Colony-Stimulating Factor/therapeutic use
- Hematologic Agents/therapeutic use
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology
- Male
- Middle Aged
- Neutropenia/chemically induced
- Pilot Projects
- Recombinant Proteins
- Retrospective Studies
- Rituximab
- Survival Analysis
- Vidarabine/administration & dosage
- Vidarabine/adverse effects
- Vidarabine/analogs & derivatives
- Vidarabine/therapeutic use
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Affiliation(s)
- Michaela Gruber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria
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12
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Schanz J, Steidl C, Fonatsch C, Pfeilstöcker M, Nösslinger T, Tuechler H, Valent P, Hildebrandt B, Giagounidis A, Aul C, Lübbert M, Stauder R, Krieger O, Garcia-Manero G, Kantarjian H, Germing U, Haase D, Estey E. Coalesced multicentric analysis of 2,351 patients with myelodysplastic syndromes indicates an underestimation of poor-risk cytogenetics of myelodysplastic syndromes in the international prognostic scoring system. J Clin Oncol 2011; 29:1963-70. [PMID: 21519021 PMCID: PMC4874202 DOI: 10.1200/jco.2010.28.3978] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The International Prognostic Scoring System (IPSS) remains the most commonly used system for risk classification in myelodysplastic syndromes (MDSs). The IPSS gives more weight to blast count than to cytogenetics. However, previous publications suggested that cytogenetics are underweighted in the IPSS. Here we investigate the prognostic impact of cytogenetic subgroups compared with that of bone marrow blast count in a large, multicentric, international patient cohort. PATIENTS AND METHODS In total, 2,351 patients with MDS who have records in the German-Austrian and the MD Anderson Cancer Center databases were included and analyzed in univariate and multivariate models regarding overall survival and risk of transformation to acute myeloid leukemia (AML). The data were analyzed separately for patients treated with supportive care without specific therapy, with AML-like chemotherapy, or with other therapy regimens (low-dose chemotherapy, demethylating agents, immune modulating agents, valproic acid, and cyclosporine). RESULTS The prognostic impact of poor-risk cytogenetic findings (as defined by the IPSS classification) on overall survival was as unfavorable as an increased (> 20%) blast count. The hazard ratio (compared with an abnormal karyotype or a bone marrow blast count < 5%) was 3.3 for poor-risk cytogenetics, 4.8 for complex abnormalities harboring chromosomes 5 and/or 7, and 3.1 for a blast count of 21% to 30% (P < .01 for all categories). The predictive power of the IPSS cytogenetic subgroups was unaffected by type of therapy given. CONCLUSION The independent prognostic impact of poor-risk cytogenetics on overall survival is equivalent to the impact of high blast counts. This finding should be considered in the upcoming revision of the IPSS.
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Affiliation(s)
- Julie Schanz
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Christian Steidl
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Christa Fonatsch
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Michael Pfeilstöcker
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Thomas Nösslinger
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Heinz Tuechler
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Peter Valent
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Barbara Hildebrandt
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Aristoteles Giagounidis
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Carlo Aul
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Michael Lübbert
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Reinhard Stauder
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Otto Krieger
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Guillermo Garcia-Manero
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Hagop Kantarjian
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Ulrich Germing
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
| | - Detlef Haase
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA.,Corresponding author: Detlef Haase, PhD, Department of Hematology and Oncology, Georg-August-University, Robert-Koch-Str 40, 37075 Goettingen, Germany; e-mail:
| | - Elihu Estey
- From the University of Goettingen, Goettingen; University of Duesseldorf, Duesseldorf; Johannes Hospital, Duisburg; University of Freiburg, Freiburg, Germany; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Medical University of Vienna; Hanusch Hospital, L. Boltzmann Institute for Leukemia Research; Medical University of Vienna, Vienna; Medical University of Innsbruck, Innsbruck; Elisabethinen Hospital, Linz, Austria; MD Anderson Cancer Center, Houston, TX; and Seattle Cancer Care Alliance, Seattle, WA
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13
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Greenberg P, Tuechler H, Schanz J, Sole F, Bennett J, Garcia-Manero G, Levis A, Malcovati L, Cazzola M, Sanz G, Cermak J, Fonatsch C, LeBeau M, Slovak M, Krieger O, Luebbert M, Magalhaes S, Miyazaki Y, Pfeilstocker M, Sekeres M, Maciejewski J, Stauder R, Tauro S, van de Loosdrecht A, Germing U, Fenaux P, Haase D. 14 Revised International Prognostic Scoring System (IPSS-R), developed by the International Prognostic Working Group for Prognosis in MDS (IWG-PM). Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70016-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Fiegl M, Erdel M, Tinhofer I, Brychtova Y, Panovska A, Doubek M, Eigenberger K, Fonatsch C, Hopfinger G, Mühlberger H, Zabernigg A, Falkner F, Gastl G, Mayer J, Greil R. Clinical outcome of pretreated B-cell chronic lymphocytic leukemia following alemtuzumab therapy: a retrospective study on various cytogenetic risk categories. Ann Oncol 2010; 21:2410-2419. [DOI: 10.1093/annonc/mdq236] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Hehlmann R, Grimwade D, Simonsson B, Apperley J, Baccarani M, Barbui T, Barosi G, Bassan R, Béné MC, Berger U, Büchner T, Burnett A, Cross NCP, de Witte TJM, Döhner H, Dombret H, Einsele H, Engelich G, Foà R, Fonatsch C, Gökbuget N, Gluckman E, Gratwohl A, Guilhot F, Haferlach C, Haferlach T, Hallek M, Hasford J, Hochhaus A, Hoelzer D, Kiladjian JJ, Labar B, Ljungman P, Mansmann U, Niederwieser D, Ossenkoppele G, Ribera JM, Rieder H, Serve H, Schrotz-King P, Sanz MA, Saussele S. The European LeukemiaNet: achievements and perspectives. Haematologica 2010; 96:156-62. [PMID: 21048032 DOI: 10.3324/haematol.2010.032979] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The only way to cure leukemia is by cooperative research. To optimize research, the European LeukemiaNet integrates 105 national leukemia trial groups and networks, 105 interdisciplinary partner groups and about 1,000 leukemia specialists from 175 institutions. They care for tens of thousands of leukemia patients in 33 countries across Europe. Their ultimate goal is to cure leukemia. Since its inception in 2002, the European LeukemiaNet has steadily expanded and has unified leukemia research across Europe. The European LeukemiaNet grew from two major roots: 1) the German Competence Network on Acute and Chronic Leukemias; and 2) the collaboration of European Investigators on Chronic Myeloid Leukemia. The European LeukemiaNet has improved leukemia research and management across Europe. Its concept has led to funding by the European Commission as a network of excellence. Other sources (European Science Foundation; European LeukemiaNet-Foundation) will take over when the support of the European Commission ends.
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Affiliation(s)
- Rüdiger Hehlmann
- Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany.
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16
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Ganster C, Wernstedt A, Kehrer-Sawatzki H, Messiaen L, Schmidt K, Rahner N, Heinimann K, Fonatsch C, Zschocke J, Wimmer K. Functional PMS2 hybrid alleles containing a pseudogene-specific missense variant trace back to a single ancient intrachromosomal recombination event. Hum Mutat 2010; 31:552-60. [PMID: 20186689 DOI: 10.1002/humu.21223] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sequence exchange between PMS2 and its pseudogene PMS2CL, embedded in an inverted duplication on chromosome 7p22, has been reported to be an ongoing process that leads to functional PMS2 hybrid alleles containing PMS2- and PMS2CL-specific sequence variants at the 5'-and the 3'-end, respectively. The frequency of PMS2 hybrid alleles, their biological significance, and the mechanisms underlying their formation are largely unknown. Here we show that overall hybrid alleles account for one-third of 384 PMS2 alleles analyzed in individuals of different ethnic backgrounds. Depending on the population, 14-60% of hybrid alleles carry PMS2CL-specific sequences in exons 13-15, the remainder only in exon 15. We show that exons 13-15 hybrid alleles, named H1 hybrid alleles, constitute different haplotypes but trace back to a single ancient intrachromosomal recombination event with crossover. Taking advantage of an ancestral sequence variant specific for all H1 alleles we developed a simple gDNA-based polymerase chain reaction (PCR) assay that can be used to identify H1-allele carriers with high sensitivity and specificity (100 and 99%, respectively). Because H1 hybrid alleles harbor missense variant p.N775S of so far unknown functional significance, we assessed the H1-carrier frequency in 164 colorectal cancer patients. So far, we found no indication that the variant plays a major role with regard to cancer susceptibility.
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Wieser R, Scheideler M, Hackl H, Engelmann M, Schneckenleithner C, Hiden K, Papak C, Trajanoski Z, Sill H, Fonatsch C. microRNAs in acute myeloid leukemia: expression patterns, correlations with genetic and clinical parameters, and prognostic significance. Genes Chromosomes Cancer 2010; 49:193-203. [PMID: 20013895 DOI: 10.1002/gcc.20740] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Acute myeloid leukemia (AML) is a malignant disease of hematopoietic cells whose emergence, course, and prognosis is affected by specific recurrent genetic alterations like chromosome aberrations and point mutations, as well as by changes in the expression of certain genes. In the past 2 years, microRNAs (miRNAs)--a novel class of small RNA molecules involved in posttranscriptional gene regulation--have also been shown to be aberrantly expressed in AML. Furthermore, specific miRNA expression patterns were found to be associated with certain genetic and cytogenetic alterations in this disease, and two studies identified miRNAs whose expression levels were predictive of survival. Interestingly, the results of these analyses showed only very limited congruence. This review summarizes published reports on the expression patterns of miRNAs in AML, and discusses possible reasons for the differences in their results.
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Affiliation(s)
- Rotraud Wieser
- Clinic of Medicine I, Medical University of Vienna, Vienna, Austria.
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Paulsson K, Haferlach C, Fonatsch C, Hagemeijer A, Andersen MK, Slovak ML, Johansson B. The idic(X)(q13) in myeloid malignancies: breakpoint clustering in segmental duplications and association with TET2 mutations. Hum Mol Genet 2010; 19:1507-14. [DOI: 10.1093/hmg/ddq024] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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19
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20
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Ganster C, Neesen J, Zehetmayer S, Jäger U, Esterbauer H, Mannhalter C, Kluge B, Fonatsch C. DNA repair polymorphisms associated with cytogenetic subgroups in B-cell chronic lymphocytic leukemia. Genes Chromosomes Cancer 2009; 48:760-7. [DOI: 10.1002/gcc.20680] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Mitterbauer M, Mitterbauer-Hohendanner G, Sperr WR, Kalhs P, Greinix HT, Fonatsch C, Haas OA, Jäger U, Mannhalter C, Lechner K. Molecular Disease Eradication is a Prerequisite for Long-term Remission in Patients with t(8;21) Positive Acute Myeloid Leukemia: a Single Center Study. Leuk Lymphoma 2009; 45:971-7. [PMID: 15291357 DOI: 10.1080/10428190310001638913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Association of long-term clinical remission and molecular disease-eradication is well established in acute myeloid leukemia (AML) patients with t(15;17) and inv(16). In patients with t(8;21) positive AML no consensus exists over the disappearance of the AML1/ETO fusion transcript during the course of disease and most studies reported reverse transcriptase polymerase chain reaction (RT-PCR) positivity as a common finding after consolidation chemotherapy, autologous and allogeneic stem cell transplantation (alloSCT). In our single center study, we performed RT-PCR monitoring in 14 patients with t(8;21) in CR1 (n = 13) and/or CR2 (n = 4). The median number of bone marrow (BM) and/or peripheral blood (PB) samples per patient was 18 (range, 2-43). In 5 out of 6 cases relapse occurred after persistence of minimal residual disease (MRD) in CR for 4-14 months. The sixth patient relapsed despite molecular remission (MR) in BM and PB for 3 months, molecular relapse preceded hematological relapse for 7 months. Eleven patients with a median follow-up of 7.8 (range, 1.5-15.4) years are in persistent CR and MR after consolidation chemotherapy (n = 7). mainly with repetitive cycles of high-dose Ara-C, autologous (n = 1) or myeloablative allogeneic (n = 3) stem cell transplantation. Molecular remission was attained immediately after alloSCT, but after 6-26 months in CR in patients with consolidation chemotherapy. In 7 patients, MRD was only studied in long-term remission. In conclusion, long-term CR was associated with persistent molecular disease-eradication. In our patients, molecular remission was a prerequisite but not a guarantee for long-term disease-free survival. Hematological relapse never occurred without prior molecular relapse. Due to the slow kinetics of AML1/ETO after consolidation chemotherapy the value of qualitative RT-PCR to predict early relapse is limited. In this situation quantitative RT-PCR might help to define individual relapse risk and to improve as well as facilitate clinical decision-making.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Disease-Free Survival
- Female
- Humans
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/mortality
- Male
- Middle Aged
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/mortality
- Predictive Value of Tests
- Recurrence
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic
- Treatment Outcome
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Affiliation(s)
- Margit Mitterbauer
- Department of Medicine I, Bone Marrow Transplantation Unit, University Hospital of Vienna, Vienna, Austria.
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22
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Porpaczy E, Bilban M, Heinze G, Gruber M, Vanura K, Schwarzinger I, Stilgenbauer S, Streubel B, Fonatsch C, Jaeger U. Gene expression signature of chronic lymphocytic leukaemia with Trisomy 12. Eur J Clin Invest 2009; 39:568-75. [PMID: 19453646 DOI: 10.1111/j.1365-2362.2009.02146.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prognosis of chronic lymphocytic leukaemia (CLL) patients is largely determined by the karyotype of the malignant clone. We have investigated the gene expression profile associated with trisomy 12 (+12). DESIGN Initially, unselected peripheral blood mononuclear cells of four patients with +12 were compared with 16 CLL controls using microarray analysis. RESULTS were validated by quantitative real-time PCR with RNA from 61 patients (29 with +12, 32 CLL controls). Results Seven genes showing the strongest correlation with +12 in microarray analysis were selected for real-time PCR: HIP1R, MYF6, SLC2A6, CD9 (overexpressed); CD200, P2RY14, RASGRP3 (underexpressed). Four genes were significantly associated with +12: HIP1R (P<0.0001), MYF6 (P=0.007), P2RY14 (P=0.014), CD200 (P=0.028). Receiver Operating Characteristic curve analysis revealed that HIP1R expression was a highly sensitive and specific marker for +12 in CLL patients. MYF6 was exclusively expressed in normal or malignant B cells in peripheral blood but was poorly predictive for +12. As expected, a number of overexpressed genes are located on chromosome 12 (HIP1R, MYF6). Interestingly, both significantly underexpressed genes (P2RY14, CD200) reside on the long arm of chromosome 3 pointing to trans-repression in this region. CONCLUSIONS Analysis of the molecular signature of trisomy 12 in CLL resulted in: (i) identification of a surrogate marker for PCR (HIP1R); (ii) observation of a gene dosage effect; and (iii) detection of specific underexpression of genes located on chromosome 3. These results should help to improve diagnosis and treatment decisions for patients with CLL and trisomy 12.
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Affiliation(s)
- E Porpaczy
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
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23
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Zatkova A, Merk S, Wendehack M, Bilban M, Muzik EM, Muradyan A, Haferlach C, Haferlach T, Wimmer K, Fonatsch C, Ullmann R. AML/MDS with 11q/MLLamplification show characteristic gene expression signature and interplay of DNA copy number changes. Genes Chromosomes Cancer 2009; 48:510-20. [DOI: 10.1002/gcc.20658] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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24
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Mallo M, Cervera J, Schanz J, Espinet B, Duch E, Luño E, Steidl C, Martín M, Germing U, Grau J, Pfeilstoecker M, Hernández-Rivas J, Noesslinger T, Calasanz M, Collado R, Fonatsch C, Bureo E, Lübbert M, Ríos R, Stauder R, Arranz E, Hildebrandt B, Slovak M, Cigudosa J, Krieger O, Pedro C, Salido M, Arenillas L, Sanz G, Sanz M, Valencia A, Florensa L, Novell L, del Cañizo C, García-Manero G, Vallespí T, Ohyashiki K, Benlloch L, Haase D, Solé F. C005 Prognostic impact of the proportion of aberrant metaphases in patients with a primary myelodysplastic syndrome. Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Haase D, Schanz J, Tuechler H, Sole F, Mallo M, Hildebrandt B, Slovak M, Ohyashiki K, Steidl C, Fonatsch C, Pfeilstoecker M, Noesslinger T, Valent P, Giagounidis A, Luebbert M, Stauder R, Krieger O, LeBeau M, Bennett J, Greenberg P, Germing U. 12 Updated cytogenetic risk features in MDS – present state. Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70012-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Fialka-Moser V, Fonatsch C, Jensen-Jarolim E, Koppensteiner R, Lang I, Mannhalter C, Pabinger I, Pavelka M, Piehslinger E, Rieder A, Schmidt-Erfurth U, Sexl V, Sibillia M, Springer-Kremser M, Wiedermann U. Der Professorinnenclub der Medizinischen Universität Wien. Wien Med Wochenschr 2009; 159:95-109. [DOI: 10.1007/s10354-009-0652-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 11/13/2008] [Indexed: 11/30/2022]
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27
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Valent P, Hofmann WK, Büsche G, Sotlar K, Horny HP, Haase D, Haferlach T, Kern W, Bettelheim P, Baumgartner C, Sperr WR, Nösslinger T, Wimazal F, Giagounidis AA, Lübbert M, Krieger O, Kolb HJ, Stauder R, Pfeilstöcker M, Gattermann N, Fonatsch C, Aul C, Germing U. Meeting report: Vienna 2008 Workshop of the German-Austrian Working Group for Studying Prognostic Factors in Myelodysplastic Syndromes. Ann Hematol 2009; 88:607-11. [PMID: 19148644 DOI: 10.1007/s00277-008-0673-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 12/14/2008] [Indexed: 11/29/2022]
Abstract
Criteria, scoring systems, and treatment algorithms for myelodysplastic syndromes (MDS) have been updated repeatedly in recent years. This apparently results from increased awareness and early recognition of the disease, an increasing number of new diagnostic and prognostic markers and tools, and new therapeutic options that may change the course and thus prognosis in MDS. To address these challenges and to create useful new diagnostic and prognostic parameters and scores, the German-Austrian Working Group for Studying Prognostic Factors in MDS was established in 2003 and later was extended to centers in Switzerland (D-A-CH group). In addition, the group cooperates with the European LeukemiaNet, the MDS Foundation, and other national and international working groups in order to improve diagnosis and prognostication. The current article represents a meeting report from the latest workshop organized by the group in Vienna in October 2008.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria.
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28
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Vanura K, Le T, Esterbauer H, Spath F, Porpaczy E, Shehata M, Eigenberger K, Hauswirth A, Skrabs C, Kromer E, Schwarzinger I, Streubel B, Steininger C, Fonatsch C, Stilgenbauer S, Wagner O, Gaiger A, Jager U. Autoimmune conditions and chronic infections in chronic lymphocytic leukemia patients at diagnosis are associated with unmutated IgVH genes. Haematologica 2008; 93:1912-6. [DOI: 10.3324/haematol.12955] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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29
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Wimazal F, Sperr W, Kundi M, Vales A, Fonatsch C, Thalhammer-Scherrer R, Schwarzinger I, Valent P. Prognostic significance of serial determinations of lactate dehydrogenase (LDH) in the follow-up of patients with myelodysplastic syndromes. Ann Oncol 2008; 19:970-6. [DOI: 10.1093/annonc/mdm595] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Haas K, Kundi M, Sperr WR, Esterbauer H, Ludwig WD, Ratei R, Koller E, Gruener H, Sauerland C, Fonatsch C, Valent P, Wieser R. Expression and prognostic significance of different mRNA 5'-end variants of the oncogene EVI1 in 266 patients with de novo AML: EVI1 and MDS1/EVI1 overexpression both predict short remission duration. Genes Chromosomes Cancer 2008; 47:288-98. [PMID: 18181178 DOI: 10.1002/gcc.20532] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Rearrangements of chromosome band 3q26.2 lead to overexpression of the EVI1 gene and are associated with a poor prognosis in myeloid malignancies. EVI1 is also overexpressed in some cases without 3q26 rearrangements. To uncover its prognostic significance in this patient group, however, it may be necessary to distinguish among several known 5'-end variants of its mRNA. According to a recent report, overexpression of the transcript variant EVI1_1d was associated with shortened survival in acute myeloid leukemia (AML), but overexpression of MDS1/EVI1, whose protein product differs structurally and functionally from that of all other known EVI1 5'-end variants, was not. The aim of the present study was to determine, for the first time, the expression and prognostic significance of all known EVI1 5'-end variants in AML. Quantitative RT-PCR was used to measure the expression of EVI1_1a, EVI1_1b, EVI1_1d, EVI1_3L, and MDS1/EVI1 in 266 samples from patients with de novo AML. To correlate expression of the EVI1 5'-end variants with survival parameters, regression analyses were performed. 41/266 patients (15.4%) overexpressed at least one, but more often several or all, EVI1 transcript type(s). High expression of each of the EVI1 mRNA variants, including MDS1/EVI1, was significantly associated with shortened continuous complete remission in the total patient population as well as in the subgroups of patients with intermediate risk or normal cytogenetics. The present study therefore shows that high levels of each of the known EVI1 mRNA 5'-end variants represents an adverse prognostic factor in de novo AML without 3q26 rearrangements. This article contains Supplementary Material available at http://www.interscience.wiley.com/jpages/1045-2257/suppmat.
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Affiliation(s)
- Katja Haas
- Department of Medical Genetics, Medical University of Vienna, Vienna, Austria
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31
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Steidl C, Schanz J, Pfeilstöcker M, Nösslinger T, Hildebrandt B, Kuendgen A, Lübbert M, Kunzmann R, Giagounidis A, Aul C, Trümper L, Krieger O, Stauder R, Müller TH, Wimazal F, Valent P, Fonatsch C, Germing U, Haase D. Growing Evidence for an Underestimation of Poor-Risk Cytogenetics in the International Prognostic Scoring System in Myelodysplastic Syndromes. ACTA ACUST UNITED AC 2007. [DOI: 10.3816/clk.2007.n.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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Kratz CP, Niemeyer CM, Jüttner E, Kartal M, Weninger A, Schmitt-Graeff A, Kontny U, Lauten M, Utzolino S, Rädecke J, Fonatsch C, Wimmer K. Childhood T-cell non-Hodgkin's lymphoma, colorectal carcinoma and brain tumor in association with café-au-lait spots caused by a novel homozygous PMS2 mutation. Leukemia 2007; 22:1078-80. [PMID: 18007577 DOI: 10.1038/sj.leu.2405008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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33
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Wimazal F, Fonatsch C, Thalhammer R, Schwarzinger I, Müllauer L, Sperr WR, Bennett JM, Valent P. Idiopathic cytopenia of undetermined significance (ICUS) versus low risk MDS: The diagnostic interface. Leuk Res 2007; 31:1461-8. [PMID: 17507091 DOI: 10.1016/j.leukres.2007.03.015] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 01/17/2007] [Accepted: 03/02/2007] [Indexed: 11/28/2022]
Abstract
It may sometimes be difficult to diagnose low risk MDS in patients with mild cytopenia. We report on 10 patients with mild to marked, unexplained cytopenia without definitive signs of a myeloid neoplasm. In two patients, a karyotype-abnormality (trisomy 14; monosomy 7) was detected in a small subset of bone marrow cells. Progression to overt MDS was seen in two patients including the one with monosomy 7. In the remaining cases, no MDS developed in a follow-up of at least 6 months. The phrase "idiopathic cytopenia of undetermined significance (ICUS)", as also suggested by Mufti and co-workers, is proposed and long term follow-up is recommended to assess the evolution.
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Affiliation(s)
- Friedrich Wimazal
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
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34
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Tuschl K, Fritz B, Herle M, Fonatsch C, Bodamer OA. Trisomy 1q42.3-qter and monosomy 21q22.3-qter associated with ear anomaly, facial dysmorphology, psychomotor retardation, and epilepsy: delineation of a new syndrome. Am J Med Genet A 2007; 143A:2065-9. [PMID: 17676599 DOI: 10.1002/ajmg.a.31792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Karin Tuschl
- Biochemical and Paediatric Genetics, Department of General Paediatrics, University Children's Hospital, Medical University Vienna, Vienna, Austria
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35
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Zatkova A, Fonatsch C, Sperr WR, Valent P. A patient with de novo AML M1 and t(16;21) with karyotype evolution. Leuk Res 2007; 31:1319-21. [PMID: 17126398 DOI: 10.1016/j.leukres.2006.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Revised: 10/13/2006] [Accepted: 10/16/2006] [Indexed: 10/23/2022]
MESH Headings
- Aged
- Chromosome Aberrations
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 21/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/classification
- Leukemia, Myeloid, Acute/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic/genetics
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36
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Haase D, Germing U, Schanz J, Pfeilstöcker M, Nösslinger T, Hildebrandt B, Kundgen A, Lübbert M, Kunzmann R, Giagounidis AAN, Aul C, Trümper L, Krieger O, Stauder R, Müller TH, Wimazal F, Valent P, Fonatsch C, Steidl C. New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients. Blood 2007; 110:4385-95. [PMID: 17726160 DOI: 10.1182/blood-2007-03-082404] [Citation(s) in RCA: 559] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We have generated a large, unique database that includes morphologic, clinical, cytogenetic, and follow-up data from 2124 patients with myelodysplastic syndromes (MDSs) at 4 institutions in Austria and 4 in Germany. Cytogenetic analyses were successfully performed in 2072 (97.6%) patients, revealing clonal abnormalities in 1084 (52.3%) patients. Numeric and structural chromosomal abnormalities were documented for each patient and subdivided further according to the number of additional abnormalities. Thus, 684 different cytogenetic categories were identified. 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). A total of 13 rare abnormalities were identified with good (+1/+1q, t(1q), t(7q), del(9q), del(12p), chromosome 15 anomalies, t(17q), monosomy 21, trisomy 21, and -X), intermediate (del(11q), chromosome 19 anomalies), or poor (t(5q)) prognostic impact, respectively. The prognostic relevance of additional abnormalities varied considerably depending on the chromosomes affected. 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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Affiliation(s)
- Detlef Haase
- Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany.
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37
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Abstract
Zusammenfassung
Im Gefolge einer Vielzahl von genetisch bedingten Erkrankungen, wie den DNA-Reparatur-Defizienz-Syndromen, Tumordispositions-, Immundefizienz-, Cancer-Family- und Bone-Marrow-Failure-Syndromen sowie bei einigen angeborenen Chromosomenanomalien werden oft Leukämien und andere hämatologische Neoplasien beobachtet. In letzter Zeit konnten darüber hinaus in Familien mit erhöhter Leukämieinzidenz konstitutionelle Mutationen spezifischer Gene identifiziert werden, die auch bei sporadischen Leukämien in Form von somatischen Mutationen involviert sind. Neben diesen Mutationen mit hoher Penetranz scheinen Genveränderungen mit niedriger Penetranz oder auch Polymorphismen von Genen, die bei der Zellproliferation, der DNA-Reparatur, der Apoptose, der Detoxifizierung u. a. m. eine Rolle spielen, die Disposition zur Leukämieentwicklung bzw. den Krankheitsverlauf zu beeinflussen. Diese neuen Erkenntnisse über konstitutionelle, zu Leukämien disponierende genetische Veränderungen könnten die Kluft zwischen angeborenen und erworbenen genetischen Erkrankungen allmählich überbrücken.
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Affiliation(s)
- C. Fonatsch
- Aff1 grid.22937.3d 0000000092598492 Department für Medizinische Genetik Medizinische Universität Wien Währinger Straße 10 1090 Wien Österreich
| | - K. Wimmer
- Aff1 grid.22937.3d 0000000092598492 Department für Medizinische Genetik Medizinische Universität Wien Währinger Straße 10 1090 Wien Österreich
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Wimmer K, Roca X, Beiglböck H, Callens T, Etzler J, Rao AR, Krainer AR, Fonatsch C, Messiaen L. Extensive in silico analysis of NF1 splicing defects uncovers determinants for splicing outcome upon 5' splice-site disruption. Hum Mutat 2007; 28:599-612. [PMID: 17311297 DOI: 10.1002/humu.20493] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We describe 94 pathogenic NF1 gene alterations in a cohort of 97 Austrian neurofibromatosis type 1 patients meeting the NIH criteria. All mutations were fully characterized at the genomic and mRNA levels. Over half of the patients carried novel mutations, and only a quarter carried recurrent minor-lesion mutations at 16 mutational warm spots. The remaining patients carried NF1 microdeletions (7%) and rare recurring mutations. Thirty-six of the mutations (38%) altered pre-mRNA splicing, and fall into five groups: exon skipping resulting from mutations at authentic splice sites (type I), cryptic exon inclusion caused by deep intronic mutations (type II), creation of de novo splice sites causing loss of exonic sequences (type III), activation of cryptic splice sites upon authentic splice-site disruption (type IV), and exonic sequence alterations causing exon skipping (type V). Extensive in silico analyses of 37 NF1 exons and surrounding intronic sequences suggested that the availability of a cryptic splice site combined with a strong natural upstream 3' splice site (3'ss)is the main determinant of cryptic splice-site activation upon 5' splice-site disruption. Furthermore, the exonic sequences downstream of exonic cryptic 5' splice sites (5'ss) resemble intronic more than exonic sequences with respect to exonic splicing enhancer and silencer density, helping to distinguish between exonic cryptic and pseudo 5'ss. This study provides valuable predictors for the splicing pathway used upon 5'ss mutation, and underscores the importance of using RNA-based techniques, together with methods to identify microdeletions and intragenic copy-number changes, for effective and reliable NF1 mutation detection.
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Affiliation(s)
- K Wimmer
- Department of Medical Genetics, Medical University of Vienna, Vienna, Austria.
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39
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Valent P, Wimazal F, Fonatsch C, Thalhammer R, Schwarzinger I, Müllauer L, Sperr W, Bennett J. P006 Idiopathic cytopenia of uncertain significance (ICUS) versus low risk MDS: the diagnostic interface. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70076-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Valent P, Horny HP, Bennett JM, Fonatsch C, Germing U, Greenberg P, Haferlach T, Haase D, Kolb HJ, Krieger O, Loken M, van de Loosdrecht A, Ogata K, Orfao A, Pfeilstöcker M, Rüter B, Sperr WR, Stauder R, Wells DA. Definitions and standards in the diagnosis and treatment of the myelodysplastic syndromes: Consensus statements and report from a working conference. Leuk Res 2007; 31:727-36. [PMID: 17257673 DOI: 10.1016/j.leukres.2006.11.009] [Citation(s) in RCA: 373] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Revised: 11/14/2006] [Accepted: 11/14/2006] [Indexed: 11/29/2022]
Abstract
The classification, scoring systems, and response criteria for myelodysplastic syndromes (MDS) have recently been updated and have become widely accepted. In addition, several new effective targeted drugs for patients with MDS have been developed. The current article provides a summary of updated and newly proposed markers, criteria, and standards in MDS, with special reference to the diagnostic interface and refinements in evaluations and scoring. Concerning the diagnostic interface, minimal diagnostic criteria for MDS are proposed, and for patients with unexplained cytopenia who do not fulfill these criteria, the term 'idiopathic cytopenia of uncertain significance' (ICUS) is suggested. In addition, new diagnostic and prognostic parameters, histopathologic and immunologic determinants, proposed refinements in scoring systems, and new therapeutic approaches are discussed. Respective algorithms and recommendations should facilitate diagnostic and prognostic evaluations in MDS, selection of patients for therapies, and the conduct of clinical trials.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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41
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Kainz B, Shehata M, Bilban M, Kienle D, Heintel D, Krömer-Holzinger E, Le T, Kröber A, Heller G, Schwarzinger I, Demirtas D, Chott A, Döhner H, Zöchbauer-Müller S, Fonatsch C, Zielinski C, Stilgenbauer S, Gaiger A, Wagner O, Jäger U. Overexpression of the paternally expressed gene10 (PEG10) from the imprinted locus on chromosome 7q21 in high-risk B-cell chronic lymphocytic leukemia. Int J Cancer 2007; 121:1984-1993. [PMID: 17621626 DOI: 10.1002/ijc.22929] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report high expression of the maternally imprinted gene PEG10 in high-risk B-CLL defined by high LPL mRNA expression. Differential expression was initially identified by microarray analysis and confirmed by real time PCR in 42 B-CLL patients. mRNA expression ranged from 0.3- to 375.4-fold compared to normal peripheral blood mononuclear cells (PBMNC). Expression levels in CD19+ B-CLL cells were 100-fold higher than in B-cells from healthy donors. PEG10 expression levels in B-CLL patient samples remained stable over time even after chemotherapy. High PEG10 expression correlated with high LPL expression (p=0.001) and a positive Coombs' test (p=0.04). Interestingly, similar expression patterns were observed for the neighbouring imprinted gene sarcoglycan-epsilon (SGCE). Monoallelic expression and maintained imprinting of PEG10 were found by allele- or methylation-specific PCR. The intensity of intracellular staining of PEG10 protein corresponded to mRNA levels as confirmed by immunofluorescence staining. Short term knock-down of PEG10 in B-CLL cells and HepG2 cells was not associated with changes in cell survival but resulted in a significant change in the expression of 80 genes. However, long term inhibition of PEG10 led to induction of apoptosis in B-CLL cells. Our data indicate (i) a prognostic value of PEG10 in B-CLL patients; (ii) specific deregulation of the imprinted locus at 7q21 in high-risk B-CLL; (iii) a potential functional and biological role of PEG10 protein expression. Altogether, PEG10 represents a novel marker in B-CLL.
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MESH Headings
- Alleles
- Apoptosis Regulatory Proteins
- Biomarkers, Tumor
- Cell Line, Tumor
- Chromosomes, Human, Pair 7/genetics
- DNA Methylation
- DNA-Binding Proteins
- Down-Regulation
- Gene Expression Regulation, Neoplastic
- Genomic Imprinting/genetics
- Health
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Nuclear Proteins/genetics
- Polysaccharides/metabolism
- Proteins/genetics
- Proteins/metabolism
- RNA, Messenger/genetics
- RNA, Small Interfering/genetics
- RNA-Binding Proteins
- Risk Factors
- Survival Rate
- Ubiquitin-Protein Ligases/genetics
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Affiliation(s)
- Birgit Kainz
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Medhat Shehata
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
- K. Landsteiner Institute for Cytokine and Tumor Microenvironment, Vienna, Austria
| | - Martin Bilban
- Department of Clinical Chemistry and Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Dirk Kienle
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Daniel Heintel
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Trang Le
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Alexander Kröber
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Gerwin Heller
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Ilse Schwarzinger
- Department of Clinical Chemistry and Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Dita Demirtas
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
- K. Landsteiner Institute for Cytokine and Tumor Microenvironment, Vienna, Austria
| | - Andreas Chott
- Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Hartmut Döhner
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Sabine Zöchbauer-Müller
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Christa Fonatsch
- Department of Human Genetics, Medical University of Vienna, Vienna, Austria
| | - Christoph Zielinski
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
- Center of Excellence in Clinical and Experimental Oncology (CLEXO), Vienna, Austria
| | - Stephan Stilgenbauer
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
- German CLL Study Group
| | - Alexander Gaiger
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oswald Wagner
- Department of Clinical Chemistry and Laboratory Medicine, Medical University of Vienna, Vienna, Austria
- Center of Excellence in Clinical and Experimental Oncology (CLEXO), Vienna, Austria
| | - Ulrich Jäger
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
- Center of Excellence in Clinical and Experimental Oncology (CLEXO), Vienna, Austria
- German CLL Study Group
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42
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Haferlach C, Rieder H, Lillington DM, Dastugue N, Hagemeijer A, Harbott J, Stilgenbauer S, Knuutila S, Johansson B, Fonatsch C. Proposals for standardized protocols for cytogenetic analyses of acute leukemias, chronic lymphocytic leukemia, chronic myeloid leukemia, chronic myeloproliferative disorders, and myelodysplastic syndromes. Genes Chromosomes Cancer 2007; 46:494-9. [PMID: 17311250 DOI: 10.1002/gcc.20433] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The impact of cytogenetic characterization based on chromosome banding analyses and fluorescence in situ hybridization on clinical decision making has increased dramatically during recent years. Therefore, laboratory techniques have to be optimized to provide reliable results for optimal patient care. In addition, quick and correct results save time and money by preventing unnecessary additional diagnostics and suboptimal treatment approaches. It was our aim to present proposals for standardized protocols to improve the diagnosis, and hence the treatment outcome, of hematologic malignancies.
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MESH Headings
- Acute Disease
- Chromosome Aberrations
- Cytogenetic Analysis/methods
- Diagnosis, Differential
- Humans
- Karyotyping
- Leukemia/diagnosis
- Leukemia/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Myelodysplastic Syndromes/diagnosis
- Myelodysplastic Syndromes/genetics
- Myeloproliferative Disorders/diagnosis
- Myeloproliferative Disorders/genetics
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43
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Zatkova A, Schoch C, Speleman F, Poppe B, Mannhalter C, Fonatsch C, Wimmer K. GAB2 is a novel target of 11q amplification in AML/MDS. Genes Chromosomes Cancer 2006; 45:798-807. [PMID: 16736498 DOI: 10.1002/gcc.20344] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Chromosome arm 11q amplifications involving the mixed lineage leukemia gene (MLL) locus are rare but recurrent aberrations in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). We have recently shown that in addition to the MLL core amplicon, independent sequences in 11q23-24 and/or 11q13.5 are coamplified within the same cytogenetic markers in 90% and 60% of patients, respectively. Here we further narrow down the minimal amplicon in 11q13.5 to 1.17 Mb by means of semi-quantitative PCR and FISH analyses. The newly defined amplicon contains seven genes, including the GRB2-associated binding protein 2 (GAB2). Using real-time RT-PCR we show a significant transcriptional upregulation of GAB2 in the patients who have GAB2 coamplified with MLL. Thus, the adaptor molecule GAB2 that has already been shown to enhance oncogenic signaling in other neoplasias appears as a novel target of 11q amplification in AML/MDS.
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Affiliation(s)
- Andrea Zatkova
- Abteilung für Humangenetik, Klinisches Institut für Medizinische und Chemische Labor Diagnostik (KIMCL), Medizinische Universität Wien, Währinger Strasse 10, A-1090 Vienna, Austria.
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44
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Saussele S, Adam K, Hochhaus A, Béné MC, Büchner T, Burnett A, Finazzi G, Fonatsch C, Gluckman E, Gökbuget N, Grimwade DJ, Haferlach T, Hallek M, Hasford J, Hoelzer D, Ljungman P, Niederwieser D, Serve H, Simonsson B, de Witte TJ, Hehlmann R. Klinische Forschung im „European LeukemiaNet”. Dtsch Med Wochenschr 2006; 131:2423-6. [PMID: 17054061 DOI: 10.1055/s-2006-955027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Saussele
- III. Medizinische Universitätsklinik, Klinikum Mannheim der Universität Heidelberg, 68305 Mannheim.
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45
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Storlazzi CT, Fioretos T, Surace C, Lonoce A, Mastrorilli A, Strömbeck B, D'Addabbo P, Iacovelli F, Minervini C, Aventin A, Dastugue N, Fonatsch C, Hagemeijer A, Jotterand M, Mühlematter D, Lafage-Pochitaloff M, Nguyen-Khac F, Schoch C, Slovak ML, Smith A, Solè F, Van Roy N, Johansson B, Rocchi M. MYC-containing double minutes in hematologic malignancies: evidence in favor of the episome model and exclusion of MYC as the target gene. Hum Mol Genet 2006; 15:933-42. [PMID: 16452126 DOI: 10.1093/hmg/ddl010] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Double minutes (dmin)-circular, extra-chromosomal amplifications of specific acentric DNA fragments-are relatively frequent in malignant disorders, particularly in solid tumors. In acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), dmin are observed in approximately 1% of the cases. Most of them consist of an amplified segment from chromosome band 8q24, always including the MYC gene. Besides this information, little is known about their internal structure. We have characterized in detail the genomic organization of 32 AML and two MDS cases with MYC-containing dmin. The minimally amplified region was shown to be 4.26 Mb in size, harboring five known genes, with the proximal and the distal amplicon breakpoints clustering in two regions of approximately 500 and 600 kb, respectively. Interestingly, in 23 (68%) of the studied cases, the amplified region was deleted in one of the chromosome 8 homologs at 8q24, suggesting excision of a DNA segment from the original chromosomal location according to the 'episome model'. In one case, sequencing of both the dmin and del(8q) junctions was achieved and provided definitive evidence in favor of the episome model for the formation of dmin. Expression status of the TRIB1 and MYC genes, encompassed by the minimally amplified region, was assessed by northern blot analysis. The TRIB1 gene was found over-expressed in only a subset of the AML/MDS cases, whereas MYC, contrary to expectations, was always silent. The present study, therefore, strongly suggests that MYC is not the target gene of the 8q24 amplifications.
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Affiliation(s)
- Clelia Tiziana Storlazzi
- Department of Genetics and Microbiology, University of Bari, Via Amendola 165/A, 70126 Bari, Italy
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46
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Gleissner B, Goekbuget N, Rieder H, Arnold R, Schwartz S, Diedrich H, Schoch C, Heinze B, Fonatsch C, Bartram CR, Hoelzer D, Thiel E. CD10- pre-B acute lymphoblastic leukemia (ALL) is a distinct high-risk subgroup of adult ALL associated with a high frequency of MLL aberrations: results of the German Multicenter Trials for Adult ALL (GMALL). Blood 2005; 106:4054-6. [PMID: 16123216 DOI: 10.1182/blood-2005-05-1866] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Immunophenotyping disclosed CD10 negativity in 70 of 2408 cases of B-lineage acute lymphoblastic leukemia (ALL), although other criteria followed classification of pre-B ALL (eg, cytoplasmic immunoglobulin positivity). These blasts showed high myeloid antigen expression (60% CD65 positivity) and reacted with antibody 7.1 in 95% of the cases. MLL-AF4 fusion transcripts or an 11q23/MLL rearrangement or both were evident in 46 of 56 samples (82%). Although 83% of the patients achieved complete remission, the remission duration remained remarkably low: 141 days for MLL rearrangement-positive and 245 days for MLL rearrangement-negative CD10(-) pre-B ALL. Thus, the overall survival probability 3 years after diagnosis was 0.34 +/- 0.20 SE in MLL-rearrangement-negative versus 0.12 +/- 0.06 SE in MLL rearrangement-positive CD10- pre-B ALL. Our data identify CD10- cytoplasmic immunoglobulin-positive pre-B ALL as a rare (2.2%) but distinct immuno-subtype of adult ALL that is characterized by a high MLL rearrangement rate and a worse outcome.
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Affiliation(s)
- Beate Gleissner
- Department of Internal Medicine III, Campus Benjamin Franklin, Charité Universitätsmedizin, Hindenburgdamm 30, 12200 Berlin, Germany.
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47
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Wimmer K, Decker M, Mayatepek E, Beiglböck H, Eggermann T, Kehrer-Sawatzki H, Fonatsch C, Rosenbaum T. Silver-Russell syndrome-like features in a patient carrying a novel NF1 mutation. Pediatr Res 2005; 58:1265-8. [PMID: 16306205 DOI: 10.1203/01.pdr.0000183661.81772.f8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mutations in the NF1 gene (17q11.2) cause neurofibromatosis type 1 (NF1), a pleiotropic and progressive autosomal dominant disorder with marked variability of clinical expression. Clinical diagnosis is usually readily achieved in most adult and adolescent patients due to the presence of at least two of the classic signs of NF1. However, the absence of many of the disease-defining features in young children frequently renders definite diagnosis impossible in this age group. Particularly, clinical diagnosis is challenging in young patients whose phenotypical presentation does not lie within the common spectrum of "typical" NF1 features. Sensitive and reliable molecular genetic testing can be of great help in these cases. Here, we report clinical and molecular findings in a 2-year-old boy with features of NF1. Severe growth retardation together with other dysmorphic features was also suggestive for Silver-Russell syndrome (SRS) in this patient. Molecular genetic testing identified a novel NF1 mutation and, thus, enabled a confident NF1 diagnosis despite the unusual phenotypical presentation in this patient.
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Affiliation(s)
- Katharina Wimmer
- Department of Human Genetics, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Austria
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48
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Sperr WR, Drach J, Hauswirth AW, Ackermann J, Mitterbauer M, Mitterbauer G, Foedinger M, Fonatsch C, Simonitsch-Klupp I, Kalhs P, Valent P. Myelomastocytic Leukemia: Evidence for the Origin of Mast Cells from the Leukemic Clone and Eradication by Allogeneic Stem Cell Transplantation. Clin Cancer Res 2005; 11:6787-92. [PMID: 16203765 DOI: 10.1158/1078-0432.ccr-05-1064] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Myelomastocytic leukemia is a term used for patients with advanced myeloid neoplasms, in whom elevated numbers of immature atypical mast cells are found, but criteria for a primary mast cell disease are not met. The origin of mast cells in these patients is presently unknown. PATIENT AND METHODS We have analyzed clonality of mast cells in an 18-year-old patient suffering from acute myeloid leukemia with a complex karyotype including a t(8;21) and mastocytic transformation with a huge increase in immature mast cells and elevated serum tryptase level, but no evidence for a primary mast cell disease/mastocytosis. RESULTS As assessed by in situ fluorescence hybridization combined with tryptase staining, both the tryptase-negative blast cells and the tryptase-positive mast cells were found to contain the t(8;21)-specific AML1/ETO fusion gene. Myeloablative stem cell transplantation resulted in complete remission with consecutive disappearance of AML1/ETO transcripts, decrease of serum tryptase to normal range, and disappearance of neoplastic mast cells. CONCLUSION These data suggest that mast cells directly derive from the leukemic clone in patients with myelomastocytic leukemia.
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MESH Headings
- Adolescent
- Antigens, CD34/biosynthesis
- Biomarkers, Tumor
- Bone Marrow Cells/metabolism
- CD2 Antigens/biosynthesis
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Flow Cytometry
- Granulocyte Precursor Cells/metabolism
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Mast Cells/cytology
- Mast Cells/metabolism
- Proto-Oncogene Proteins c-kit/biosynthesis
- Receptors, Interleukin-2/biosynthesis
- Serine Endopeptidases/blood
- Serine Endopeptidases/metabolism
- Stem Cell Transplantation/methods
- Translocation, Genetic
- Transplantation, Homologous
- Tryptases
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Affiliation(s)
- Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Austria.
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49
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Storlazzi CT, Fioretos T, Surace C, Lonoce A, Mastrorilli A, Strömbeck B, D’Addabbo P, Iacovelli F, Minervini C, Aventin A, Dastugue N, Fonatsch C, Hagemeijer A, Jotterand M, Lafage-Pochitaloff M, Nguyen-Khac F, Schoch C, Slovak M, Smith A, Solè F, Van Roy N, Johansson B, Rocchi M. O29: Detailed characterization of MYC-containing double minutes in hematologic malignancies: exclusion of MYC as the target gene and evidence in favor of an episome model in the genesis of dmin. Eur J Med Genet 2005. [DOI: 10.1016/j.ejmg.2005.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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50
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Germing U, Hildebrandt B, Pfeilstöcker M, Nösslinger T, Valent P, Fonatsch C, Lübbert M, Haase D, Steidl C, Krieger O, Stauder R, Giagounidis AAN, Strupp C, Kündgen A, Mueller T, Haas R, Gattermann N, Aul C. Refinement of the international prognostic scoring system (IPSS) by including LDH as an additional prognostic variable to improve risk assessment in patients with primary myelodysplastic syndromes (MDS). Leukemia 2005; 19:2223-31. [PMID: 16193087 DOI: 10.1038/sj.leu.2403963] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The international prognostic scoring system (IPSS) is considered the gold standard for risk assessment in primary myelodysplastic syndromes (MDS). This score includes several prognostic factors except serum lactate dehydrogenase (LDH). We evaluated the prognostic power of LDH as an additional variable in IPSS-based risk assessment. For this purpose, a total of 892 patients with primary MDS registered by the Austrian-German cooperative MDS study group was analyzed retrospectively. Multivariate analysis confirmed the value of established parameters such as medullary blasts, karyotype and peripheral cell counts and showed that elevated LDH was associated with decreased overall survival (P<0.00005) and increased risk of AML development (P<0.00005), independent of the system used to classify MDS (FAB or WHO). Moreover, elevated LDH was found to be a significant predictor of poor survival within each IPSS risk group and within each FAB group except RAEB-T. To exploit these results for refined prognostication, each IPSS risk group was split into two separate categories (A=normal LDH vs B=elevated LDH). Using this LDH-assisted approach, it was possible to identify MDS patients with unfavorable prognosis within the low and intermediate IPSS risk groups. We propose that the IPSS+LDH score should improve clinical decision-making and facilitate proper risk stratification in clinical trials.
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Affiliation(s)
- U Germing
- Department of Hematology, Oncology and Clinical Immunology , Heinrich-Heine-University, Germany.
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