Decoding Bone Marrow Fibrosis in Myelodysplastic Syndrome

Publication date: Available online 14 January 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Megan Melody, Najla Al Ali, Ling Zhang, Hanadi Ramadan, Eric Padron, David Sallman, Kendra Sweet, Jeffrey Lancet, Alan List, John M. Bennett, Rami KomrokjiSummaryBackgroundBone marrow fibrosis (BMF), a poor prognostic factor in myelodysplastic syndromes (MDS), in the context of new risk stratifications of MDS has not been fully explored. Here, we examined the relationship between BMF in MDS and survival outcomes and explored the landscape of somatic gene mutations in the setting of BMF.MethodsWe retrospectively evaluated 2624 MDS patients for BMF who were divided into two groups: grade 0-2 BMF (96%) and severe/grade 3 BMF (4%) based on analysis presented. Commonly MDS tested acquired somatic mutations were also compared between those two groups of patients with available next-generation sequencing data.FindingsOnly grade 3 BMF was associated with worse overall survival independent from IPSS-R (Hazard ratio 1.6 (95% CI 1.2- 1.9) (P <.005)). More patients with severe BMF were classified as MDS-EB1 and EB-2 by WHO 2016 classification, higher risk IPSS and high/very high IPSS-R risk category than patients with grade 0-2 BMF. A complex karyotype, higher bone marrow myeloblasts, lower platelets, and higher rate of elevated lactate dehydrogenase were more observed in patients with severe BMF. No differences in response to hypomethylating agents or lenalidomide were observed...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research