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New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients.
[monosomy 21]
We
have
generated
a
large
,
unique
database
that
includes
morphologic
,
clinical
,
cytogenetic
,
and
follow-up
data
from
2124
patients
with
myelodysplastic
syndromes
(
MDSs
)
at
4
institutions
in
Austria
and
4
in
Germany
.
Cytogenetic
analyses
were
successfully
performed
in
2072
(
97
.
6
%
)
patients
,
revealing
clonal
abnormalities
in
1084
(
52
.
3
%
)
patients
.
Numeric
and
structural
chromosomal
abnormalities
were
documented
for
each
patient
and
subdivided
further
according
to
the
number
of
additional
abnormalities
.
Thus
,
684
different
cytogenetic
categories
were
identified
.
The
impact
of
the
karyotype
on
the
natural
course
of
the
disease
was
studied
in
1286
patients
treated
with
supportive
care
only
.
Median
survival
was
53
.
4
months
for
patients
with
normal
karyotypes
(
n
=
612
)
and
8
.
7
months
for
those
with
complex
anomalies
(
n
=
166
)
.
A
total
of
13
rare
abnormalities
were
identified
with
good
(
+
1
/
+
1
q
,
t
(
1
q
)
,
t
(
7
q
)
,
del
(
9
q
)
,
del
(
12
p
)
,
chromosome
15
anomalies
,
t
(
17
q
)
,
monosomy
21
,
trisomy
21
,
and
-
X
)
,
intermediate
(
del
(
11
q
)
,
chromosome
19
anomalies
)
,
or
poor
(
t
(
5
q
)
)
prognostic
impact
,
respectively
.
The
prognostic
relevance
of
additional
abnormalities
varied
considerably
depending
on
the
chromosomes
affected
.
For
all
World
Health
Organization
(
WHO
)
and
French
-
American
-
British
(
FAB
)
classification
system
subtypes
,
the
karyotype
provided
additional
prognostic
information
.
Our
analyses
offer
new
insights
into
the
prognostic
significance
of
rare
chromosomal
abnormalities
and
specific
karyotypic
combinations
in
MDS
.
Diseases
Validation
Diseases presenting
"specific karyotypic combinations"
symptom
monosomy 21
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