PMID- 32765089 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220416 IS - 1179-1322 (Print) IS - 1179-1322 (Electronic) IS - 1179-1322 (Linking) VI - 12 DP - 2020 TI - Patients of Myelodysplastic Syndrome with Mild/Moderate Myelofibrosis and a Monosomal Karyotype are Independently Associated with an Adverse Prognosis: Long-Term Follow-Up Data. PG - 5881-5891 LID - 10.2147/CMAR.S258875 [doi] AB - PURPOSE: The aim of our study was to evaluate the clinical characteristics of myelodysplastic syndrome (MDS) patients with concomitant mild-to-moderate myelofibrosis (MF), and to assess its independent prognostic role in MDS patients diagnosed by World Health Organization 2016 classification (WHO2016C) with long-term follow-up. PATIENTS AND METHODS: A total of 157 patients with primary MDS associated with or without MF were examined retrospectively with long-term follow-up. MF graded as MF-1/MF-2 was defined as "mild/moderate". Cytogenetics testing and fluorescence in situ hybridization (FISH) were also conducted in all MDS patients. RESULTS: Thirty-four (21.7%) of 157 MDS patients had MF. Also, 24 (15.3%) MDS patients based on WHO2016 criteria were defined as MF-1 and 10 (6.4%) as MF-2. MDS patients with MF-1/2 had a higher prevalence of death (p=0.002), leukemic progression (p=0.013), O blood type (p=0.039) as well as less hypercellular proliferation (p<0.001) and less supportive treatment (p=0.003) compared with those without mild/moderate MF. Cytogenetics testing did not show a significant difference between MDS patients with and without MF. Multivariate analyses showed that MF (mild/moderate), a monosomal karyotype (MK) and % bone-marrow blasts were independently associated with shorter overall survival (OS) and progression-free survival (PFS). Age was an independent indicator of the adverse OS of MDS patients. Compared with those without MF, MDS patients with mild/moderate MF were significantly associated with worse OS and PFS in MK-negative subgroups and relatively low-risk Revised International Prognostic Scoring System for Myelodysplastic Syndromes (IPSS-R) stratification in long-term follow-up. CONCLUSION: Mild/moderate myelofibrosis and monosomal karyotype are independent indicators of a poor clinical outcome in MDS patients. In long-term follow-up, MDS with mild/moderate MF can be a prognostic marker for MDS patients with a specific MK stratification and IPSS-R stratification. CI - (c) 2020 Wang et al. FAU - Wang, Na AU - Wang N AUID- ORCID: 0000-0001-9552-0524 AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. AD - School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China. FAU - Xu, Hongzhi AU - Xu H AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Li, Qing AU - Li Q AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Fang, Xiaosheng AU - Fang X AUID- ORCID: 0000-0002-4515-9731 AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Liu, Jie AU - Liu J AUID- ORCID: 0000-0002-0384-1898 AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Sui, Xiaohui AU - Sui X AUID- ORCID: 0000-0001-7284-6062 AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Zhang, Lingyan AU - Zhang L AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Jiang, Yujie AU - Jiang Y AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. FAU - Wang, Xin AU - Wang X AUID- ORCID: 0000-0001-8051-1481 AD - Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People's Republic of China. AD - Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People's Republic of China. AD - School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China. AD - Shandong Provincial Engineering Research Center of Lymphoma, Jinan, Shandong 250021, People's Republic of China. AD - National Clinical Research Center for Hematologic Diseases, Jinan, Shandong 250021, People's Republic of China. LA - eng PT - Journal Article DEP - 20200716 PL - New Zealand TA - Cancer Manag Res JT - Cancer management and research JID - 101512700 PMC - PMC7371562 OTO - NOTNLM OT - cytogenetics OT - myelodysplastic syndromes OT - myelofibrosis OT - prognosis COIS- The authors declare no conflicts of interest in this work. EDAT- 2020/08/09 06:00 MHDA- 2020/08/09 06:01 PMCR- 2020/07/16 CRDT- 2020/08/09 06:00 PHST- 2020/04/19 00:00 [received] PHST- 2020/06/25 00:00 [accepted] PHST- 2020/08/09 06:00 [entrez] PHST- 2020/08/09 06:00 [pubmed] PHST- 2020/08/09 06:01 [medline] PHST- 2020/07/16 00:00 [pmc-release] AID - 258875 [pii] AID - 10.2147/CMAR.S258875 [doi] PST - epublish SO - Cancer Manag Res. 2020 Jul 16;12:5881-5891. doi: 10.2147/CMAR.S258875. eCollection 2020.