Pretransplant Chromosome Genomic Array Testing Improves Prognostication for Myelofibrosis Patients Undergoing...

Area of Science:

• Hematology
• Genetics
• Oncology

Background:

• Myelofibrosis prognosis relies on risk stratification systems, but tools for predicting transplant outcomes are limited.
• Chromosome genomic array testing (CGAT) offers superior diagnostic yield for chromosomal anomalies compared to karyotype and FISH.
• CGAT is not yet a routine clinical test for myelofibrosis.

Purpose of the Study:

• To evaluate if pre-transplant CGAT improves prognostication of post-transplant outcomes in myelofibrosis patients.
• To compare the prognostic capability of CGAT with existing risk categorization systems like DIPSS plus.

Main Methods:

• Retrospective study of 44 myelofibrosis patients undergoing hematopoietic cell transplantation (2000-2017).
• Assessed prognostic significance of CGAT, DIPSS plus, and gene mutation counts for relapse-free survival (RFS), overall survival (OS), and GVHD.
• Median follow-up of 91 months.

Main Results:

• Abnormal CGAT results were found in 55% of patients; 41% had copy-neutral loss of heterozygosity (cnLOH).
• CGAT demonstrated significant prognostic value, especially when combined with DIPSS-plus and mutation counts (P = 1e-08 for RFS).
• Specific anomalies like U2AF1 mutation and 1q gain were associated with worse RFS; ASXL1 mutations correlated with chronic GVHD onset.

Conclusions:

• Pre-transplant CGAT analysis enhances existing risk stratification tools for myelofibrosis.
• CGAT may be considered for routine clinical testing to improve transplant outcome prediction.