Frequency of del(12p) is commonly underestimated in myelodysplastic syndromes: Results from a German diagnostic study in comparison with an international control group

In myelodysplastic syndromes (MDS), deletion of the short arm of chromosome 12 (del(12p)) is usually a small abnormality, rarely detected as a single aberration by chromosome banding analysis (CBA) of bone marrow metaphases. Del(12p) has been described in 0.6 to 5% of MDS patients at initial diagnosis and is associated with a good to intermediate prognosis as a sole anomaly according to current scoring systems. Here, we present the results of a systematic del(12p) testing in a German prospective diagnostic study (clinicaltrials.gov: NCT01355913) on 367 MDS patients in whom CD34+ peripheral blood cells were analysed for the presence of del(12p) by sequential fluorescence in situ hybridization (FISH) analyses. A cohort of 2,902 previously published MDS patients diagnosed by CBA served as control. We demonstrate that, using a sensitive FISH technique, 12p deletion occurs significantly more frequently in MDS than previously described (7.6% by CD34+ PB‐FISH vs. 1.6% by CBA, P < 0.001) and is often associated with other aberrations (93% by CD34+ PB‐FISH vs. 60% by CBA). Additionally, the detection rate can be increased by repeated analyses in a patient over time which is important for the patient´s prognosis to distinguish a sole anomaly from double or complex aberrations. To our knowledge, this is the first study to screen for 12p deletions with a suitable probe for ETV6/TEL in 12p13. Our data suggest that the supplement of a probe for the detection of a 12p deletion to common FISH probe panels helps to avoid missing a del(12p), especially as part of more complex aberrations. © 2015 Wiley Periodicals, Inc.

[1]  F. Solé,et al.  Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group , 2015, Haematologica.

[2]  G. Mufti,et al.  Clinical Characteristics and Treatment Allocations in Patients with Myelodysplastic Syndromes and Monosomy 7: Results from an International Multicenter Study Suggest That Hypomethylating Agents Significantly Improve Overall- and AML-Free Survival in Patients Classified As Very High Risk By IPSS-R , 2014 .

[3]  M. Tormo,et al.  Multivariate time‐dependent comparison of the impact of lenalidomide in lower‐risk myelodysplastic syndromes with chromosome 5q deletion , 2014, British Journal of Haematology.

[4]  R. Chen,et al.  Acquisition of cytogenetic abnormalities in patients with IPSS defined lower‐risk myelodysplastic syndrome is associated with poor prognosis and transformation to acute myelogenous leukemia , 2013, American journal of hematology.

[5]  R. Schlenk,et al.  Molecular cytogenetic monitoring from CD34+ peripheral blood cells in myelodysplastic syndromes: first results from a prospective multicenter German diagnostic study. , 2013, Leukemia research.

[6]  K. Götze,et al.  Sequential combination of azacitidine and lenalidomide in del(5q) higher-risk myelodysplastic syndromes or acute myeloid leukemia: a phase I study , 2013, Leukemia.

[7]  K. Götze,et al.  Sequential Combination of Azacitidine and Lenalidomide Can Target the TP53 -Mutated Clone in Del(5q) Higher-Risk Myelodysplastic Syndromes , 2012 .

[8]  L. Arenillas,et al.  Prognostic value of trisomy 8 as a single anomaly and the influence of additional cytogenetic aberrations in primary myelodysplastic syndromes , 2012, British journal of haematology.

[9]  Luca Malcovati,et al.  Revised international prognostic scoring system for myelodysplastic syndromes. , 2012, Blood.

[10]  F. Solé,et al.  Will a peripheral blood (PB) sample yield the same diagnostic and prognostic cytogenetic data as the concomitant bone marrow (BM) in myelodysplasia? , 2012, Leukemia research.

[11]  C. Steidl,et al.  New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  E. Estey,et al.  Coalesced multicentric analysis of 2,351 patients with myelodysplastic syndromes indicates an underestimation of poor-risk cytogenetics of myelodysplastic syndromes in the international prognostic scoring system. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  C. Steidl,et al.  Impact of adjunct cytogenetic abnormalities for prognostic stratification in patients with myelodysplastic syndrome and deletion 5q , 2011, Leukemia.

[14]  F. Solé,et al.  Will a Peripheral Blood (PB) Sample Yield the Same Diagnostic and Prognostic Cytogenetic Data as the Concomitant Bone Marrow (BM) In Myelodysplasia? An International Study Comparing Cytogenetics and Interphase FISH Using Parallel PB and BM Samples , 2010 .

[15]  E. Campo,et al.  Do we need to do fluorescence in situ hybridization analysis in myelodysplastic syndromes as often as we do? , 2010, Leukemia research.

[16]  L. Trümper,et al.  FISH analysis of circulating CD34+ cells as a new tool for genetic monitoring in MDS: verification of the method and application to 27 MDS patients. , 2010, Leukemia research.

[17]  L. Gondek,et al.  FISH and SNP-A karyotyping in myelodysplastic syndromes: improving cytogenetic detection of del(5q), monosomy 7, del(7q), trisomy 8 and del(20q). , 2010, Leukemia research.

[18]  R. Pinheiro,et al.  Comparison of I-FISH and G-banding for the detection of chromosomal abnormalities during the evolution of myelodysplastic syndrome. , 2009, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[19]  C. Chang,et al.  Multiple distinct clones may co-exist in different lineages in myelodysplastic syndromes. , 2009, Leukemia research.

[20]  Thomas H Müller,et al.  New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients. , 2007, Blood.

[21]  M. Cazzola,et al.  Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  L. Rimsza,et al.  Efficacy of lenalidomide in myelodysplastic syndromes. , 2005, The New England journal of medicine.

[23]  J. Cigudosa,et al.  Identification of novel cytogenetic markers with prognostic significance in a series of 968 patients with primary myelodysplastic syndromes. , 2005, Haematologica.

[24]  P. Fenaux Myelodysplastic syndromes: From pathogenesis and prognosis to treatment. , 2004, Seminars in hematology.

[25]  Cervera,et al.  Incidence, characterization and prognostic significance of chromosomal abnormalities in 640 patients with primary myelodysplastic syndromes , 2000, British journal of haematology.

[26]  W. Ludwig,et al.  Correlation of cytogenetic, molecular cytogenetic, and clinical findings in 59 patients with ANLL or MDS and abnormalities of the short arm of chromosome 12 , 1998, British journal of haematology.

[27]  T Hamblin,et al.  International scoring system for evaluating prognosis in myelodysplastic syndromes. , 1997, Blood.

[28]  P. Marynen,et al.  Molecular characterization of 12p abnormalities in hematologic malignancies: deletion of KIP1, rearrangement of TEL, and amplification of CCND2. , 1996, Blood.

[29]  James M. Roberts,et al.  TEL and KIP1 define the smallest region of deletions on 12p13 in hematopoietic malignancies. , 1995, Blood.

[30]  R. Kucherlapati,et al.  Fluorescence in situ hybridization mapping of translocations and deletions involving the short arm of human chromosome 12 in malignant hematologic diseases. , 1994, Blood.

[31]  Iscn International System for Human Cytogenetic Nomenclature , 1978 .

[32]  Y. Rumpler,et al.  International Standing Committee on Human Cytogenetic Nomenclature , 1976 .