Impact Of Philadelphia Chromosome On Clinical Features And Prognosis Of Patients With Myelodysplastic Disorder

Objective: To investigate the effect of Philadelphia chromosome(Ph)on clinical features and prognosis of patients with myelodysplastic syndrome(MDS).Methods: 69 cases of MDS from our hospital and other major medical databases(Pub Med,Google Academic,CNKI,Wanfang)Medical Database were included and divided into Ph positive group and Ph negative group according to whether accompanied by Ph.Clinical data of patients in the two groups were collected and compared,including clinical characteristics(sex,age,WHO type,peripheral blood cell count,bone marrow primitive cell percentage,morphological changes,IPSS-R score)and prognosis(overall survival(OS),leukemia-free survival(LFS)).In addition,in order to obtain more accurate results,we further performed subgroup analysis and divided the Ph positive group into isolated Ph positive group and non-isolated Ph positive group according to whether there were other chromosomal abnormalities except Ph.The Ph negative MDS patients were divided into normal karyotype group and non-Ph positive chromosome abnormal group according to whether they were accompanied by chromosomal abnormalities.The clinical features and prognosis of each group were compared.Results: Analysis of clinical features showed that white blood cell counts were significantly higher in Ph positive patients than in Ph negative patients(P=0.0007).The IPSS-R score and the percentage of bone marrow primitive cells in Ph positive patients were also higher than those in Ph positive patients,and the differences between the two groups were close to but not significant.There were no significant differences in age,sex,morphological changes and disease types between the two groups.The OS and LFS in Ph positive group were significantly shortened,especially in non-isolated Ph positive group.In addition,we also found an important finding in the subgroup analysis.Analysis of patient characteristics showed that the IPSS-R score of isolated Ph positive MDS patients was significantly lower than that of non-Ph positive MDS patients with chromosome abnormalities.In theory,patients with non-Ph abnormal MDS with chromosome abnormalities have a worse prognosis than patients with isolated Ph positive MDS.However,the opposite result was found in the survival analysis,suggesting that Ph may be an important predictor of poor prognosis of MDS,and if it can be included in IPSS-R in the future,it may be an important supplement to the current scoring criteria.Univariate analysis showed that high white blood cell count and abnormal Ph were risk factors for OS in MDS patients,and elevated bone marrow blast ratio and abnormal Ph were risk factors for LFS in MDS patients.Multivariate analysis revealed independent risk factors for LFS and OS in MDS patients with Ph abnormalities.Conclusions: Ph positive MDS has a high white blood cell count,a poor prognosis and a high risk of transformation to leukemia.In addition,Ph may be an important predictor of poor prognosis in MDS patients,and if it can be included in IPSS-R in future,it may be an important supplement to the current scoring criteria.