Evidence map›Paper›PMID 39921387›Full record

Trial reportGenes, chromosomes & cancer2025

Influence of Cytogenetics on the Outcome of Patients With High-Risk Myelodysplastic Syndrome Including Deletion 5q Treated With Azacitidine With or Without Lenalidomide.

Bengt Rasmussen, Lars Nilsson, Magnus Tobiasson, Martin Jädersten, Hege Garelius, Ingunn Dybedal, Kirsten Grønbaek, Elisabeth Ejerblad, Fryderyk Lorenz, Max Flogegård and 10 more

Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase II
In one paragraph

Trial report in Genes, chromosomes & cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01556477 (A Multicentre Open Randomized Phase II Study of the Efficacy and Safety of Azacitidine Alone or in Combination With Lenalidomide in High-risk Myeloid Disease), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01556477 phase2unknown statusnot on this map

A Multicentre Open Randomized Phase II Study of the Efficacy and Safety of Azacitidine Alone or in Combination With Lenalidomide in High-risk Myeloid Disease (High-risk Myelodysplastic Syndrome and Acute Myeloid Leukemia) With a Karyotype Including Del(5q)

TypeinterventionalSponsorNordic MDS GroupRan2012 to 2014Enrolled72ConditionsMyelodysplastic Syndrome, Acute Myelogenous LeukemiaArmsAzacitidine, azacitidine + lenalidomide
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Bengt RasmussenDivision of Hematology, Department of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID 0000-0003-0972-9853
Lars NilssonDepartment of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Magnus TobiassonDepartment of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Martin JäderstenDepartment of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Hege GareliusSection of Hematology and Coagulation, Department of Specialist Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Ingunn DybedalDepartment of Hematology, Oslo University Hospital, Oslo, Norway.
Kirsten GrønbaekDepartment of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Elisabeth EjerbladDepartment of Medical Science, Section of Hematology, Uppsala University, Uppsala, Sweden.
Fryderyk LorenzDepartment of Medical Biosciences, Umeå University, Umeå, Sweden.
Max FlogegårdDepartment of Internal Medicine, Falun General Hospital, Falun, Sweden.
Claus Werenberg MarcherDepartment of Hematology, Odense University Hospital, Odense, Denmark.
Lucia CavalierDepartment of Clinical Genetics, Karolinska University Hospital, Solna, Sweden.
Freja EbelingComprehensive Cancer Center, Division of Hematology, Helsinki University Hospital, Helsinki, Finland.
Astrid Marta OlsnesFaculty of Medicine, University of Bergen, Bergen, Norway.
Jan Maxwell NørgaardDepartment of Hematology, Aarhus University Hospital, Aarhus, Denmark.
Leonie SaftDepartment of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital and Institute, Stockholm, Sweden.
Lars MöllgårdSection of Hematology and Coagulation, Department of Specialist Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eva Hellström-LindbergDepartment of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Brigitte SchlegelbergerDepartment of Human Genetics, Hannover Medical School, Hannover, Germany.
Gudrun GöhringDepartment of Human Genetics, Hannover Medical School, Hannover, Germany.

Funding

CancerfondenCelgeneNordic Cancer Union
6 · The paper itself

Abstract

In myelodysplastic syndromes (MDS), cytogenetic characteristics of the malignant bone marrow cells influence the clinical course. The aim of this study was to evaluate whether cytogenetics is useful to predict outcome and response in patients with del(5q) under azacitidine (AZA) ± lenalidomide (LEN) therapy. We therefore performed comprehensive cytogenetic analyses in MDS patients with del(5q) treated within the randomized phase II trial NMDSG10B. Seventy-two patients were enrolled in the study and 46 patients (64%) had sufficient cytogenetics at inclusion and response evaluation. Karyotyping was significantly more sensitive during follow-up to detect del(5q) compared to FISH, 34 patients (97%) versus 27 patients (77%) (p = 0.027). The overall response rate (ORR) did not differ between the 11 patients with < 3 aberrations (median 1 aberration) and the 59 patients with ≥ 3 aberrations (median 7 aberrations, range 3-16), while ≥ 3 aberrations were associated with shorter overall survival (OS), 9.9 months versus 25.2 months (p = 0.004). OS was significantly shorter in patients with unbalanced translocation of 5q than patients with del (5)(q14q34), 8.4 months versus 21.1 months (p = 0.004). Both complex karyotype and multi-hit TP53 alterations were more frequent in patients with unbalanced translocations of 5q versus del (5)(q14q34), 98% and 88% versus 67% and 47% (each p = < 0.001). Most patients with cytogenetic progression had multi-hit TP53 alterations at inclusion. Cytogenetic progression occurred at a similar frequency in the AZA arm and in the AZA + LEN arm. In summary, this study in homogenously treated MDS patients with different abnormalities of 5q demonstrates the influence of cytogenetics on treatment results. Trial Registration: EudraCT number: 2011-001639-21; ClinicalTrials.gov identifier: NCT01556477.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsAzacitidineMyelodysplastic SyndromesAdultAgedAged, 80 and overChromosome DeletionChromosomes, Human, Pair 5Cytogenetic AnalysisFemaleHumansLenalidomideMaleMiddle AgedThalidomideTreatment OutcomeAzacitidineLenalidomideThalidomideazacitidinedeletion 5qhigh‐risk myelodysplastic syndromelenalidomideoutcomeTP53

Identifiers

PMID39921387
PMCPMC11806368

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.