Significance of cytogenetic-risk categories and refined international prognostic scoring system for overall survival in primary myelofibrosis: A single-center experience

Djordje Taušan; Zoran  Kostić; Damjan  Slavković; Branimir  Nešković; Dubravko  Bokonjić; Sandra  Šipetić-Grujičić; Nenad  Ratković; Vesna  Šuljagić

doi:10.2298/VSP180521125T

Djordje Taušan Military Medical Academy, Pulmonology Clinic
Zoran Kostić Military Medical Academy, Clinic for General Surgery ; University of Defence, Faculty of Medicine of Military Medical Academy
Damjan Slavković Military Medical Academy, Clinic for General Surgery
Branimir Nešković Military Medical Academy, Clinic for General Surgery
Dubravko Bokonjić University of Defence, Faculty of Medicine of Military Medical Academy
Sandra Šipetić-Grujičić University of Belgrade, Faculty of Medicine, Institute of Epidemiology
Nenad Ratković University of Defence, Faculty of Medicine of Military Medical Academy; Military Medical Academy, Clinic for Emergency Internal Medicine
Vesna Šuljagić Military Medical Academy, Department of Nosocomial Infections Control, University of Defence, Faculty of Medicine of Military Medical Academy

DOI: https://doi.org/10.2298/VSP180521125T

Keywords: cross infection;, pneumonia;, digestive system surgical procedures;, risk factors;, incidence;, mortality

Abstract

Background/Aim. Primary myelofibrosis (PMF) is a chronic, malignant hematological disease characterized by a leucoerythroblastic blood picture, anisopoikilocytosis teardrop-shaped erythrocytes, different degrees of bone marrow fibrosis and hepatosplenomegaly due to extramedullary hematopoiesis. Among genetic specificities of the disease, those that stand out are chromosomal aberrations in pathological, myeloid blood cells. The aim of this study was to examine the prognostic significance of clinical, hematologic and cytogenetic parameters in PMF. Methods. A retrospective study included 144 patients with PMF. Karyotypes were analyzed using conventional cytogenetic methods. Results. The chromosome examinations were successful in 126 (88%) patients and failed in the remainder ones (12%). Karyotype was abnormal in 36/126 (29%) subjects at presentation. The most frequent changes included +9, 13q- and 20q- (28%). Other abnormalities were: aberrations of chromosome 18 and 16, deletions (9q-, 12p-, 7q-, 5q-, 6q-, 8q-), trisomies (+1q, +8, +10, +21), monosomies (-7, -11), 3q inversion and loss of Y chromosome. We detected four novel balanced translocations in PMF: t(17;22)(q11;q13), t(15;17)(q22;q25), t(9;12)(q22;q24) and t(2;4)(q21;p16), one constitutional translocation-rob(13;14)(q10;q10) and some new karyotype anomalies ˗ deletion of both homologues, hyperdiploidy and the coexistence of unrelated pathological clones. Conclusion. Chromosomal aberrations had a significant influence on overall survival of patients with PMF according to the refined cytogenetic-risk of the International Prognostic Scoring System (Refined CIPSS) (p = 0.004). Our patients matched the pattern of chromosome aberrations usually observed in PMF but some newly registered, balanced translocations and other rare karyotype anomalies were recorded as well.

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