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Leuk Res. 2018 Oct;73:51-57. doi: 10.1016/j.leukres.2018.08.022. Epub 2018 Sep 6.

Differing clinical features between Japanese and Caucasian patients with myelodysplastic syndromes: Analysis from the International Working Group for Prognosis of MDS.

Author information

1
Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: y-miyaza@nagasaki-u.ac.jp.
2
L. Boltzmann Institute for Leukemia Research, Vienna, Austria.
3
Hospital Universitario La Fe, Valencia, Spain.
4
University Medical Center, Clinics of Haematology and Medical Oncology, Göttingen, Germany.
5
The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
6
Institut de Recerca contra la Leucèmia Josep Carreras, Barcelona, Spain.
7
James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, United States.
8
St James's University Hospital, Leeds, United Kingdom.
9
Hopital Avicenne, Assistance Publique-Hopitaux de Paris (AP-HP)/University of Paris XIII, Bobigny, France.
10
Hopital Cochin, AP-HP, University of Paris V, Paris, France.
11
Heinrich-Heine University Hospital, Dusseldorf, Germany.
12
Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and University of Pavia, Pavia, Italy.
13
Institute of Hematology and Blood Transfusion, Praha, Czech Republic.
14
Medical University of Vienna, Vienna, Austria.
15
University of Chicago Comprehensive Cancer Research Center, Chicago, IL, United States.
16
Department of Pathology, University of New Mexico, Albuquerque, NM, United States.
17
MDS Unit, Ematologia, AOU Careggi, Università degli Studi di Firenze, Firenze, Italy.
18
University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany.
19
Cleveland Clinic, Cleveland, OH, United States.
20
Elisabethinen Hospital, Linz, Austria.
21
Federal University of Ceara, Fortaleza, Brazil.
22
Hanusch Hospital and Ludwig Boltzmann Cluster Oncology, Vienna, Austria.
23
Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Austria.
24
University Hospital of Innsbruck, Innsbruck, Austria.
25
University of Dundee, Dundee, United Kingdom.
26
Hospital Universitario Vall d'Hebron, Barcelona, Spain.
27
VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
28
Stanford Cancer Institute, Stanford, CA, United States.

Abstract

Clinical features of myelodysplastic syndromes (MDS) could be influenced by many factors, such as disease intrinsic factors (e.g., morphologic, cytogenetic, molecular), extrinsic factors (e.g, management, environment), and ethnicity. Several previous studies have suggested such differences between Asian and European/USA countries. In this study, to elucidate potential differences in primary untreated MDS between Japanese (JPN) and Caucasians (CAUC), we analyzed the data from a large international database collected by the International Working Group for Prognosis of MDS (300 and 5838 patients, respectively). JPN MDS were significantly younger with more severe cytopenias, and cytogenetic differences: less del(5q) and more +1/+1q, -1/del(1p), der(1;7), -9/del(9q), del(16q), and del(20q). Although differences in time to acute myeloid leukemia transformation did not occur, a significantly better survival in JPN was demonstrated, even after the adjustment for age and FAB subtypes, especially in lower, but not in higher prognostic risk categories. Certain clinical factors (cytopenias, blast percentage, cytogenetic risk) had different impact on survival and time to transformation to leukemia between the two groups. Although possible confounding events (e.g., environment, diet, and access to care) could not be excluded, our results indicated the existence of clinically relevant ethnic differences regarding survival in MDS between JPN and CAUC patients. The good performance of the IPSS-R in both CAUC and JP patients underlines that its common risk model is adequate for CAUC and JP.

KEYWORDS:

Clinical features; Ethnicity; Karyotype; Myelodysplastic syndromes; Survival

PMID:
30219650
DOI:
10.1016/j.leukres.2018.08.022
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