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发布于:2018-6-21 20:44:48  访问:35 次 回复:0 篇
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A New Untold Information Around Imatinib That You Ought To Read Or End Up Being Left Out
By IPSS cytogenetic prognostic subgroups, MDS with isolated trisomy 8 was categorized as expected: 69��5% in intermediate-1, 23��7% in intermediate-2 and 6��8% in high selleck risk. Significant differences were seen when the median survival time of the 1676 MDS with normal karyotype of the GESMD registry was compared with the 72 MDS with trisomy 8 as a sole change, with poorest prognosis for patients with trisomy 8 as a single anomaly (88?months vs. 34��3?months; P?=?0��001). This data supports the idea of the negative impact of trisomy 8 in MDS. Although, trisomy 8 has been considered an alteration which confers an intermediate prognosis to MDS (Morel et?al, 1993; Greenberg et?al, 1997; Sole et?al, 2005; Schanz et?al, 2012), some studies have suggested that trisomy 8 confers a worse outcome than other cytogenetic alterations included in the intermediate IPSS risk group (Bernasconi et?al, 2007). These results could explain the high incidence of trisomy 8 in cases with RAEB-1 and RAEB-2. The median OS reported for patients of intermediate IPSS cytogenetic subgroup ranged between 23 and 32?months, and for patients with trisomy 8 as a sole change between 11 and 25?months (Greenberg et?al, 1997; Sole et?al, 2005; Bernasconi et?al, 2007; Haase et?al, 2007; Schanz et?al, 2012). Our results were not in accordance with these data; in our study the median OS for patients with isolated trisomy 8 was 34��3?months. The worst outcome reported in the previous studies is explained by the presence of cases with more than 20% of blasts and CMML. Pozdnyakova et?al (2008) reported an OS of 19?months for de novo MDS with isolated trisomy 8, Selumetinib solubility dmso but in their series, most of the patients had been treated with active experimental drugs. Imatinib This difference was also maintained for risk of AML evolution. Referring to the previous reports, the frequency of patients who progress to AML varied from 8% to 63% (Morel et?al, 1993; Sole et?al, 2000, 2005; Paulsson et?al, 2001; Bernasconi et?al, 2007). In our series 18% of patients diagnosed of MDS with trisomy 8 progressed to AML, and the probability of AML transformation was 17��7% at 2?years. The new proposals for cytogenetic categorization have regarded isolated trisomy 8, like previous IPSS classification, as an intermediate prognosis alteration (Schanz et?al, 2012). These proposals published a median OS for MDS with +8 of 23?months and a median time to AML transformation of 38��6?months, but they also considered CMML and cases with more than 20% of blasts (Schanz et?al, 2012). According to our study, MDS patients with isolated trisomy 8 should be included in the intermediate cytogenetic risk group. We observed that patients with <5% bone marrow blast bearing isolated trisomy 8 had the same prognosis as patients with <5% blasts and a normal karyotype. However, when the bone marrow blasts count is ��5%, isolated trisomy 8 implies a worse prognosis than a normal karyotype.
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