Relevance of Cytogenetics in Myelodysplastic Syndrome (MDS) in the Assessment of Hematopoietic Stem Cell Transplantation (HSCT) Survival

KORNBLIHTT, LAURA; BELLI, CAROLINA; HAMERSCHLAK, N; VIGORITO AC; RODRIGUES PEREIRA VELLOSO, ELVIRA; LOPES, LUIS FERNANDO; BARROSO, FERNANDO; CORREA, WALTER A; FUNKE, VAM; VILELA, NC; PAZ, A; HALLACK NETO, AE; SOARES, RDDA; SANTOS, TEJ; BASQUIERA, ANA L; COLTURATO, VAR; SILVA RL; STEVENAZZI, MARIANA; BETTARELLO, G; LEMES, RPG

Valencia

Simposio; 14th Symposium on Myelodysplastic Syndromes; 2017

Myelodysplastic Foundation

Cytogenetics is considered an independent prognostic factor in MDS. This impact has been increasingly acknowledged, especially with the IPSS-R classification. We evaluated 173 patients from the Latin American Register of Bone Marrow Transplantation in MDS (LARBM) in cooperation with the Argentine MDS Registry (Ar-MDS-Registry), who undergone Hematopoietic Stem Cell Transplantation (HSCT) from 1988 to 2017. We observed that only 117 (67.6%) patients (80-LARBM and 37-Ar-MDS-Registry) had been karyotyped at diagnosis. These patients were stratified according to cytogenetics as good, intermediate, and poor (according to the IPSS or/and IPSS-R) and evaluated regarding HSCT outcome. Patients showed a male predominance (51%), with most patients ranging from 51 to 60 years (28%), followed by 41 to 50 years (18%), but only 13% aged >60 years. Regarding to cytogenetic, 53% had normal and 47% presented abnormal karyotype (p=0.5762). The overall survival at 1, 3, 5 and 10 years was respectively (59.7%; 48.9%, 45.7%, 39.2%), independent of cytogenetic group. At diagnosis 4.3% were classified as very Good, 53% as Good, 29% as Intermediate and 13.7% as Poor/Very Poor, based on IPSS-R scores. The median follow-up was 36 months for Good; 38 for Intermediate and 18.65 for Poor/Very poor groups and 46.19% of all them remained alive. Survival proportion at 3 and 5 years was respectively (48.2%, 48.2%) for patients with Good, (51.4%, 42.95%) for Intermediate and (42.6%, 42.6 %) for Poor/ very Poor patients, with no change for Good and Poor/very poor groups (95% CI, 0.4352-1.172) (p=0.5762).It is noteworthy that a small percentage of patients with poor karyotype was alive 10 years after the HSCT,and, after 164 months of follow-up, 40.2% of patients from Good, 30.7% from Intermediate and no patients with Poor/very poor karyotype were alive. These outcomes reinforcing the importance of this evaluation in the context of the transplantation prognosis, which may help in the better management of these patients.