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Prognostic Impact of IPSS-R and Chromosomal Translocations in 751 Korean Patients with Primary Myelodysplastic Syndrome

 Koung Jin Suh  ;  June-Won Cheong  ;  Inho Kim  ;  Hyeoung-Joon Kim  ;  Dong-Yeop Shin  ;  Youngil Koh  ;  Sung-Soo Yoon  ;  Yoo Hong Min  ;  Jae-Sook Ahn  ;  Yeo-Kyeoung Kim  ;  Yun-Gyoo Lee  ;  Jeong-Ok Lee  ;  Soo-Mee Bang  ;  Yeung-Chul Mun  ;  Chu-Myoung Seong  ;  Yong Park  ;  Byung-Soo Kim  ;  Junshik Hong  ;  Jinny Park  ;  Jae Hoon Lee  ;  Sung-Yong Kim  ;  Hong Ghi Lee 
 PLOS ONE, Vol.11(11) : e0166245, 2016 
Journal Title
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Chromosomal translocations are rare in myelodysplastic syndrome (MDS) and their impact on overall survival (OS) and response to hypomethylating agents (HMA) is unknown. The prognostic impact of the revised International Prognostic Scoring System (IPSS-R) and for chromosomal translocations was assessed in 751 patients from the Korea MDS Registry. IPSS-R effectively discriminated patients according to leukaemia evolution risk and OS. We identified 40 patients (5.3%) carrying translocations, 30 (75%) of whom also fulfilled complex karyotype criteria. Translocation presence was associated with a shorter OS (median, 12.0 versus 79.7 months, P < 0.01). Multivariate analysis demonstrated that translocations (hazard ratio [HR] 1.64 [1.06-2.63]; P = 0.03) as well as age, sex, IPSS-R, and CK were independent predictors of OS. In the IPSS-R high and very high risk subgroup (n = 260), translocations remained independently associated with OS (HR 1.68 [1.06-2.69], P = 0.03) whereas HMA treatment was not associated with improved survival (median OS, 20.9 versus 21.2 months, P = 0.43). However, translocation carriers exhibited enhanced survival following HMA treatment (median 2.1 versus 12.4 months, P = 0.03). Our data suggest that chromosomal translocation is an independent predictor of adverse outcome and has an additional prognostic value in discriminating patients with MDS having higher risk IPSS-R who could benefit from HMA treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
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