Clinical Impact of Transformation to Acute Myeloid Leukemia in Patients With Higher-Risk Myelodysplastic Syndromes

Kota, Vamsi; Ogbonnaya, Augustina; Farrelly, Eileen; Schroader, Bridgette Kanz; Raju, Aditya; Kristo, Fjoralba; Dalal, Mehul

doi:10.2217/fon-2022-0334

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…This finding is lower than that reported by Vamsi et al, who reported that AML transformation during a 1-year follow-up was 26.9% in higher-risk MDS patients, which were patients with intermediate IPSS-R prognostic risk or greater. 16 Another study with eight years of follow-up reported AML transformation in 13.9% of MDS patients, with a median of 5 (1-23) months. 35 It has been reported that approximately 10-35% of MDS cases evolve into acute leukemia during the disease course.…”

Section: Discussionmentioning

confidence: 99%

“…15 Through the IPSS-R risk group, a clinician can differentiate patients with higher risk, with the treatment goals of delaying AML transformation and improving overall survival. 16 The current standard of management for high-risk patients includes hypomethylating agents, decitabine, azacitidine, and allogeneic stem cell transplants. 17 Cytogenetic abnormalities were abnormal in >50% of the patients at diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Cytogenetic profile and risk of transformation to acute myeloid leukemia (AML) in Indonesian patients with myelodysplastic syndrome (MDS): a pilot study

Sutandyo,

Kosasih,

Sari

et al. 2024

F1000Res

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Background Cytogenetics is a fundamental examination in the course and management of myelodysplastic syndrome (MDS) since it is widely used as a diagnostic and prognostic indicator for the disease. Some cytogenetic profiles are associated with a higher risk of acute myeloid leukemia (AML) transformation. This is the first study to evaluate the cytogenetic profile of Indonesian patients with MDS. Methods This prospective cohort study was conducted at the Cancer Center and several other referral hospitals. Patients with primary MDS aged >18 years were included in the study. Clinical examination, peripheral blood smear, and bone marrow aspiration were performed, followed by cytogenetic examination. The results were further categorized into revised international prognostic scoring system (IPSS-R) scores, and cytogenetic profiles were descriptively presented. Patients were followed up for one year to evaluate AML transformation. Results A total of 28 MDS patients, aged 66±12 years, were included in this study. The majority of the patients were male (n=17;60.7%), aged 65 years or above (n=19;67.9%), diagnosed with MDS-MLD (n=14;50%), and had an intermediate cytogenetic group (n=4;14.3%). The IPSS-R score was high in 6 (21.4%) patients and very high risk in 3 (10.7%) patients. During one-year follow-up, AML transformation occurred in 3 (10.7%) patients, and 10 (35.7%) patients ceased. Monosomy 7 was observed in 6 (21.4%) patients but in one metaphase each. Deletion of chromosome 5 (del(5)(q31)), del (16)(q21.1), and del (16)(q11.2) were found in a male patient with MDS-EB1. Conclusions Monosomy 7 and deletion of chromosome 5 have been identified in Indonesian patients with MDS. MDS-EB has the highest risk of AML transformation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cytogenetic profile and risk of transformation to acute myeloid leukemia (AML) in Indonesian patients with myelodysplastic syndrome (MDS): a pilot study

Sutandyo,

Kosasih,

Sari

et al. 2024

F1000Res

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“…Approximately 40% of patients with high-risk MDS can experience deterioration or evolution to AML [28,29]. Furthermore, MDS patients who progress to AML are at a higher risk of death than those who do not [30]. Therefore, it is vital to assess the impact of ADs on the rate of AML transformation in MDS patients as it may help to improve the survival of these patients.…”

Section: Impact Of Ads On the Rate Of Aml Transformationmentioning

confidence: 99%

Effects of Autoimmune Disorders on Myelodysplastic Syndrome Outcomes: A Systematic Review

Saowapa,

Polpichai,

Tanariyakul

et al. 2024

Hemato

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Background: Autoimmune disorders (ADs) are prevalent among patients with myelodysplastic syndrome (MDS), yet their impact on MDS outcomes, including overall survival (OS), mortality, and transformation to acute myeloid leukemia (AML), is not well defined. Methods: We conducted a systematic review of articles published up to April 2024, sourced from PubMed, Web of Science, Embase, and Google Scholar, focusing on the influence of ADs on survival and AML transformation rates in MDS patients. The methodological quality of each study was assessed using the Newcastle Ottawa Scale. Results: From 8 studies that met the inclusion criteria, ADs were present in 17.5% (3074/17,481) of MDS patients. Data analysis indicated mortality rates ranging from 15.3% to 67% in MDS patients with ADs and 12% to 69% in those without. The rate of AML transformation varied from 0% to 23% in patients with ADs compared to 4% to 30% in those without. Conclusions: The influence of ADs on survival and AML transformation in MDS patients appears variable. This systematic review highlights the need for further large-scale prospective studies to clarify the relationship between ADs and MDS outcomes.

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“…2 The risk of progression to AML among patients with high-risk MDS is high (~40%). 3 MDS is an emerging disease in the elderly (the majority of patients are aged >70 years), 4 and due to an aging population in developing countries and the recent molecular advances in detecting clonality, the case-frequency of MDS is expected to increase over time with a high impact on health resources. 5,6 As MDS is mainly a disease of the elderly, comorbidities play an important role in the presentation and symptom burden of affected patients.…”

Section: Introductionmentioning

confidence: 99%

Myelodysplastic Neoplasms: The Impact of Clonality on Inflammatory-Degenerative Diseases of the Elderly

2024

healthbook TIMES Onco Hema

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The diagnostic approach to patients with cytopenia has become highly challenging due to the heterogenic presentation of clonal hematopoietic stem cell disorders and accompanying degenerative disorders in the generally elderly population. A holistic approach with extensive clinical experience is required to recognize the potential interactions between the clonal condition and inflammatory-degenerative comorbidities in the elderly. This narrative review highlights the diagnostic challenges in the classification and risk stratification of patients with clonal hematopoiesis and myelodysplastic neoplasms, dysregulation of immune hemostasis and its impact on degenerative-inflammatory comorbidities of the elderly from the perspective of an experienced clinician.

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Clinical Impact of Transformation to Acute Myeloid Leukemia in Patients With Higher-Risk Myelodysplastic Syndromes

Cited by 7 publications

References 32 publications

Cytogenetic profile and risk of transformation to acute myeloid leukemia (AML) in Indonesian patients with myelodysplastic syndrome (MDS): a pilot study

Cytogenetic profile and risk of transformation to acute myeloid leukemia (AML) in Indonesian patients with myelodysplastic syndrome (MDS): a pilot study

Effects of Autoimmune Disorders on Myelodysplastic Syndrome Outcomes: A Systematic Review

Myelodysplastic Neoplasms: The Impact of Clonality on Inflammatory-Degenerative Diseases of the Elderly

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