Better treatment outcomes in patients with actively treated therapy-related myeloid neoplasms harboring a normal karyotype
We analyzed treatment outcomes and prognostic factors in adult patients with therapy-related myeloid neoplasms (t-MNs) to select patients who would be benefited by active anticancer treatment. After excluding 18 patients who received palliative care only and 13 patients with acute promyelocytic leuk...
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| creator | Kim, Sang-A Hong, Junshik Park, Woo Chan Shin, Dong-Yeop Koh, Youngil Kim, Inho Lee, Dong Soon Yoon, Sung-Soo |
| description | We analyzed treatment outcomes and prognostic factors in adult patients with therapy-related myeloid neoplasms (t-MNs) to select patients who would be benefited by active anticancer treatment. After excluding 18 patients who received palliative care only and 13 patients with acute promyelocytic leukemia, 72 t-MN patients (45 with acute myeloid leukemia and 27 with myelodysplastic syndrome) were retrospectively evaluated. Among them, 10 (13.9%), 32 (44.4%), and 30 patients (41.7%) had favorable, intermediate- and adverse-risk cytogenetics, respectively. Among patients with intermediate-risk cytogenetics, patients with a normal karyotype (NK; N = 20) showed superior allogeneic stem cell transplantation-censored overall survival (AC-OS) and OS compared to those with non-NK-intermediate-risk cytogenetics (P < 0.001). In the multivariate analysis, male sex, age ≥ 70 years, and unfavorable cytogenetics (non-NK-intermediate plus adverse risk cytogenetics) were associated with inferior AC-OS. Those results suggest that a more-refined subdivision of risk stratification would be necessary in patients with intermediate-risk cytogenetics. |
| doi_str_mv | 10.1371/journal.pone.0209800 |
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After excluding 18 patients who received palliative care only and 13 patients with acute promyelocytic leukemia, 72 t-MN patients (45 with acute myeloid leukemia and 27 with myelodysplastic syndrome) were retrospectively evaluated. Among them, 10 (13.9%), 32 (44.4%), and 30 patients (41.7%) had favorable, intermediate- and adverse-risk cytogenetics, respectively. Among patients with intermediate-risk cytogenetics, patients with a normal karyotype (NK; N = 20) showed superior allogeneic stem cell transplantation-censored overall survival (AC-OS) and OS compared to those with non-NK-intermediate-risk cytogenetics (P < 0.001). In the multivariate analysis, male sex, age ≥ 70 years, and unfavorable cytogenetics (non-NK-intermediate plus adverse risk cytogenetics) were associated with inferior AC-OS. Those results suggest that a more-refined subdivision of risk stratification would be necessary in patients with intermediate-risk cytogenetics.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0209800</identifier><identifier>PMID: 30596716</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute myeloid leukemia ; Acute promyeloid leukemia ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biology and Life Sciences ; Bone marrow ; Cancer therapies ; Cell survival ; Chemotherapy ; Child ; Clinical outcomes ; Cytogenetics ; Cytotoxicity ; Female ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells - physiology ; Hospitals ; Humans ; Internal medicine ; Karyotype ; Leukemia ; Leukemia, Myeloid, Acute - therapy ; Male ; Medical diagnosis ; Medical prognosis ; Medical research ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Multivariate Analysis ; Mutation ; Myelodysplastic syndrome ; Myeloid leukemia ; Neoplasms ; Patients ; Physical Sciences ; Prognosis ; Promyeloid leukemia ; Research and Analysis Methods ; Retrospective Studies ; Risk ; Stem cell transplantation ; Stem cells ; Studies ; Therapy ; Transplantation ; Transplants & implants ; Treatment Outcome ; Tumors ; Young Adult</subject><ispartof>PloS one, 2018-12, Vol.13 (12), p.e0209800-e0209800</ispartof><rights>2018 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Kim et al 2018 Kim et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-c52e46a68401e658a5675e6775f54f46f01255e960deb6661ec3ad4543418d13</citedby><cites>FETCH-LOGICAL-c526t-c52e46a68401e658a5675e6775f54f46f01255e960deb6661ec3ad4543418d13</cites><orcidid>0000-0002-7829-397X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312245/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312245/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30596716$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Sang-A</creatorcontrib><creatorcontrib>Hong, Junshik</creatorcontrib><creatorcontrib>Park, Woo Chan</creatorcontrib><creatorcontrib>Shin, Dong-Yeop</creatorcontrib><creatorcontrib>Koh, Youngil</creatorcontrib><creatorcontrib>Kim, Inho</creatorcontrib><creatorcontrib>Lee, Dong Soon</creatorcontrib><creatorcontrib>Yoon, Sung-Soo</creatorcontrib><title>Better treatment outcomes in patients with actively treated therapy-related myeloid neoplasms harboring a normal karyotype</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We analyzed treatment outcomes and prognostic factors in adult patients with therapy-related myeloid neoplasms (t-MNs) to select patients who would be benefited by active anticancer treatment. After excluding 18 patients who received palliative care only and 13 patients with acute promyelocytic leukemia, 72 t-MN patients (45 with acute myeloid leukemia and 27 with myelodysplastic syndrome) were retrospectively evaluated. Among them, 10 (13.9%), 32 (44.4%), and 30 patients (41.7%) had favorable, intermediate- and adverse-risk cytogenetics, respectively. Among patients with intermediate-risk cytogenetics, patients with a normal karyotype (NK; N = 20) showed superior allogeneic stem cell transplantation-censored overall survival (AC-OS) and OS compared to those with non-NK-intermediate-risk cytogenetics (P < 0.001). In the multivariate analysis, male sex, age ≥ 70 years, and unfavorable cytogenetics (non-NK-intermediate plus adverse risk cytogenetics) were associated with inferior AC-OS. Those results suggest that a more-refined subdivision of risk stratification would be necessary in patients with intermediate-risk cytogenetics.</description><subject>Acute myeloid leukemia</subject><subject>Acute promyeloid leukemia</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biology and Life Sciences</subject><subject>Bone marrow</subject><subject>Cancer therapies</subject><subject>Cell survival</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Clinical outcomes</subject><subject>Cytogenetics</subject><subject>Cytotoxicity</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hematopoietic Stem Cells - physiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Karyotype</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - therapy</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Mutation</subject><subject>Myelodysplastic syndrome</subject><subject>Myeloid leukemia</subject><subject>Neoplasms</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Prognosis</subject><subject>Promyeloid leukemia</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Studies</subject><subject>Therapy</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Young 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treatment outcomes in patients with actively treated therapy-related myeloid neoplasms harboring a normal karyotype</title><author>Kim, Sang-A ; Hong, Junshik ; Park, Woo Chan ; Shin, Dong-Yeop ; Koh, Youngil ; Kim, Inho ; Lee, Dong Soon ; Yoon, Sung-Soo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-c52e46a68401e658a5675e6775f54f46f01255e960deb6661ec3ad4543418d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute myeloid leukemia</topic><topic>Acute promyeloid leukemia</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biology and Life Sciences</topic><topic>Bone marrow</topic><topic>Cancer therapies</topic><topic>Cell survival</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Clinical 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karyotype</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-12-31</date><risdate>2018</risdate><volume>13</volume><issue>12</issue><spage>e0209800</spage><epage>e0209800</epage><pages>e0209800-e0209800</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We analyzed treatment outcomes and prognostic factors in adult patients with therapy-related myeloid neoplasms (t-MNs) to select patients who would be benefited by active anticancer treatment. After excluding 18 patients who received palliative care only and 13 patients with acute promyelocytic leukemia, 72 t-MN patients (45 with acute myeloid leukemia and 27 with myelodysplastic syndrome) were retrospectively evaluated. Among them, 10 (13.9%), 32 (44.4%), and 30 patients (41.7%) had favorable, intermediate- and adverse-risk cytogenetics, respectively. Among patients with intermediate-risk cytogenetics, patients with a normal karyotype (NK; N = 20) showed superior allogeneic stem cell transplantation-censored overall survival (AC-OS) and OS compared to those with non-NK-intermediate-risk cytogenetics (P < 0.001). In the multivariate analysis, male sex, age ≥ 70 years, and unfavorable cytogenetics (non-NK-intermediate plus adverse risk cytogenetics) were associated with inferior AC-OS. Those results suggest that a more-refined subdivision of risk stratification would be necessary in patients with intermediate-risk cytogenetics.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30596716</pmid><doi>10.1371/journal.pone.0209800</doi><orcidid>https://orcid.org/0000-0002-7829-397X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute myeloid leukemia Acute promyeloid leukemia Adolescent Adult Aged Aged, 80 and over Biology and Life Sciences Bone marrow Cancer therapies Cell survival Chemotherapy Child Clinical outcomes Cytogenetics Cytotoxicity Female Hematopoietic Stem Cell Transplantation Hematopoietic Stem Cells - physiology Hospitals Humans Internal medicine Karyotype Leukemia Leukemia, Myeloid, Acute - therapy Male Medical diagnosis Medical prognosis Medical research Medicine Medicine and Health Sciences Middle Aged Multivariate Analysis Mutation Myelodysplastic syndrome Myeloid leukemia Neoplasms Patients Physical Sciences Prognosis Promyeloid leukemia Research and Analysis Methods Retrospective Studies Risk Stem cell transplantation Stem cells Studies Therapy Transplantation Transplants & implants Treatment Outcome Tumors Young Adult |
| title | Better treatment outcomes in patients with actively treated therapy-related myeloid neoplasms harboring a normal karyotype |
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