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The prognostic value of circulating myeloblasts in patients with myelodysplastic syndromes

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Abstract

The prognostic value of peripheral blasts (PB) is not well-studied in patients with myelodysplastic syndromes (MDS). We evaluated the impact of PB on overall survival (OS) and transformation to acute myeloid leukemia (AML) in a large cohort. The MDS database at the Moffitt Cancer Center was retrospectively reviewed to identify patients with ≥ 1% PB (PB-MDS) and those without PB (BM-MDS). We also assessed the correlation between PB and gene mutations. One thousand seven hundred fifty-eight patients were identified, among whom 13% had PB near the time of diagnosis. PB-MDS patients were more likely to be younger with trilineage cytopenia, complex karyotype, higher-risk disease, transfusion dependence, and therapy-related MDS. The rate of AML transformation was 49 vs. 26% (p < 0.005) and median OS was 16.5 vs. 45.8 months (p < 0.005) in the PB-MDS and BM-MDS groups, respectively. In Cox regression analysis, the presence of PB was an independent prognostic covariate for OS, HR 1.57 (95% CI 1.2–2). Among 51 patients with an available gene panel, the rate of ≥ 1 gene mutation in the PB-MDS group (n = 4) was 100% compared to 81% in the BM-MDS group (n = 47). The presence of PB in MDS is an adverse independent prognostic variable that refines prognostic discrimination.

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Authors and Affiliations

  1. University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, 22 S. Greene Street, S9D04B, Baltimore, MD, 21201, USA

    Vu H. Duong

  2. Department of Malignant Hematology, H Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA

    Eric Padron, Najla H. Al Ali, Jeffrey E. Lancet, Alan F. List & Rami S. Komrokji

  3. Genoptix Medical Laboratory, Carlsbad, CA, USA

    Jeff Hall & Brian Kwok

  4. Hematopathology and Laboratory Medicine, H Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA

    Ling Zhang

  5. Immunology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA

    Pearlie K. Epling-Burnette

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  1. Vu H. Duong
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Correspondence to Vu H. Duong.

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The study was reviewed and approved by both the MCC Scientific Review Committee and Institutional Review Board. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Duong, V.H., Padron, E., Al Ali, N.H. et al. The prognostic value of circulating myeloblasts in patients with myelodysplastic syndromes. Ann Hematol 97, 247–254 (2018). https://doi.org/10.1007/s00277-017-3186-4

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  • DOI: https://doi.org/10.1007/s00277-017-3186-4

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