TY - JOUR
T1 - Comprehensive sequential genetic analysis delineating frequency, patterns, and prognostic impact of genomic dynamics in a real-world cohort of patients with lower-risk MDS
AU - Mazzeo, Paolo
AU - Ganster, Christina
AU - Wiedenhöft, John
AU - Shirneshan, Katayoon
AU - Rittscher, Katharina
AU - Brzuszkiewicz, Elzbieta B.
AU - Steinemann, Doris
AU - Schieck, Maximilian
AU - Müller-Thomas, Catharina
AU - Treiber, Hannes
AU - Braulke, Friederike
AU - Germing, Ulrich
AU - Sockel, Katja
AU - Balaian, Ekaterina
AU - Schanz, Julie
AU - Platzbecker, Uwe
AU - Götze, Katharina S.
AU - Haase, Detlef
N1 - Publisher Copyright:
© 2024 The Author(s). HemaSphere published by John Wiley & Sons Ltd on behalf of European Hematology Association.
PY - 2024/9
Y1 - 2024/9
N2 - The acquisition of subsequent genetic lesions (clonal evolution, CE) and/or the expansion of existing clones (CEXP) contributes to clonal dynamics (CD) in myelodysplastic syndromes (MDS). Although CD plays an important role in high-risk patients in disease progression and transformation into acute myeloid leukemia (AML), knowledge about CD in lower-risk MDS (LR-MDS) patients is limited due to lack of robust longitudinal data considering the long clinically stable courses of the disease. In this retrospective analysis, we delineate the frequency and the prognostic impact of CD in an unselected real-world cohort of LR-MDS patients. We screened 68 patients with a median follow-up of 40.5 months and a median of 7.5 (range: 2–22) timepoints for CE and CEXP detected by chromosomal banding analysis, fluorescence in situ hybridization, sequencing, and molecular karyotyping. In 30/68 patients, 47 CE events and a CD rate of 1 event per 4 years were documented. Of note, patients with at least 1 CE event had an increased probability for subsequent treatment. Unexpectedly, CE did not correlate with inferior outcomes, which could be reasonably explained by CD detection triggering the subsequent start of a disease-modifying therapy.
AB - The acquisition of subsequent genetic lesions (clonal evolution, CE) and/or the expansion of existing clones (CEXP) contributes to clonal dynamics (CD) in myelodysplastic syndromes (MDS). Although CD plays an important role in high-risk patients in disease progression and transformation into acute myeloid leukemia (AML), knowledge about CD in lower-risk MDS (LR-MDS) patients is limited due to lack of robust longitudinal data considering the long clinically stable courses of the disease. In this retrospective analysis, we delineate the frequency and the prognostic impact of CD in an unselected real-world cohort of LR-MDS patients. We screened 68 patients with a median follow-up of 40.5 months and a median of 7.5 (range: 2–22) timepoints for CE and CEXP detected by chromosomal banding analysis, fluorescence in situ hybridization, sequencing, and molecular karyotyping. In 30/68 patients, 47 CE events and a CD rate of 1 event per 4 years were documented. Of note, patients with at least 1 CE event had an increased probability for subsequent treatment. Unexpectedly, CE did not correlate with inferior outcomes, which could be reasonably explained by CD detection triggering the subsequent start of a disease-modifying therapy.
UR - http://www.scopus.com/inward/record.url?scp=85204800841&partnerID=8YFLogxK
U2 - 10.1002/hem3.70014
DO - 10.1002/hem3.70014
M3 - Article
AN - SCOPUS:85204800841
SN - 2572-9241
VL - 8
JO - HemaSphere
JF - HemaSphere
IS - 9
M1 - e70014
ER -