Cytogenetic analysis and RAS mutations in primary myelodysplastic syndromes

Cytogenetic analysis was performed in 60 patients with primary myelodysplas tic syndromes-diagnosed, treated, and followed in our department. In 41 cas es, the presence of the NRAS mutation was also evaluated. The aim of this s tudy was to evaluate the prognostic value of chromosomal abnormalities and NRAS mutation. The median age of the patients was 67 years (18-88 years), a nd the French-American-British classification was as follows: refractory an emia 26, refractory anemia with ring sideroblasts 4, refractory anemia with excess of blast cells 15, refractory anemia with ex-cess of blast cells in transformation 3, and chronic myelomonocytic leukemia 12. Survival analysi s was performed for the patients with a normal (n = 35), an abnormal (n = 2 5) karyotype and with a single (n = 25) or multiple (n = 10) cytogenetic ab normalities. Abnormal karyotypes were detected in 25 of the 60 patients (41 .6%). Fifteen of these patients had a single and 10 had two or more lesions . The median survival of the patients with a normal (33.1 months) and with an abnormal (36.5 months) karyotype was not significantly different. Patien ts with multiple lesions had a reduced median survival compared with patien ts with single anomalies (19.2 versus 39.7 months, p = 0.5). Patients with an abnormal karyotype progressed to acute leukemia more frequently compared with patients without lesions (36 versus 28.6%, p = 0.5). NRAS mutation rr as detected in 2 of 10 CMMoL patients studied and in none of the 31 patien ts with other types of myelodysplastic syndrome. Marrow blasts more than 10 % significantly affected survival. (C) Elsevier Science Inc., 1999. All rig hts reserved.