Prognostic relevance of cytogenetic systems in myelodysplastic syndromes

BELLI C; BESTACH Y; CORREA W; SAKAMOTO F; FLORES MG; BASQUEIRA AL; RIVAS MM; CAMPESTRI R; BENGIÓ R; LARRIPA I

LEUKEMIA AND LYMPHOMA

TAYLOR & FRANCIS LTD

Lugar: Londres; Año: 2012 vol. 53 p. 1640 - 1642

1042-8194

Cytogenetic analysis has been recognized as an independent prognostic factor, and its inclusion within diff erent systems has contributed to improvement in assessing the prognosis of MDS. Stratifying cytogenetic findings in MDS started with counting the number of altered chromosomes as defined in the Lille system in 1993. Th e second published system was defined in 1995 as the Lausanne  Bournemouth index, which emphasizes the number of alterations. In 1997, the IPSS recognized that the most frequent cytogenetic findings, such as Y, 5q , 20 , trisomia 8 and 7/7q , belong to specific groups of risk, thus becoming the most widely accepted cytogenetic categories for assessing prognosis. However, the IPSS included in the intermediate group a number of low-frequency cytogenetic alterations that make it heterogeneous, which is a matter of debate. Later the IPSS was revised, and the risk of some less frequent cytogenetic findings was specified, dividing karyotypes into five categories (IPSS-R). Recently we have determined that the presence of an isolated deletion, excluding 7q , is a good prognostic finding, while the presence of a monosomal karyotype (MK) is a high-risk marker (IPSS-MK). This system has shown independent prognostic impact and a better discriminating power compared with the IPSS categories