Portal de Periódicos da CAPES

Prognostic relevance of serum thymidine kinase in primary myelodysplastic syndromes: relationship to development of acute myeloid leukaemia

1995; Wiley; Volume: 90; Issue: 1 Linguagem: Inglês

10.1111/j.1365-2141.1995.tb03390.x

1365-2141

Pellegrino Musto, Carlo Bodenizza, Antonietta Falcone, Giovanni D’Arena, Potito Rosario Scalzulli, Gianni Perla, Sergio Modoni, LUIGI PARLATORE, Maria Rosa Valvano, M Carotenuto,

Hematological disorders and diagnostics

The aim of this study was to evaluate the possible prognostic relevance of thymidine kinase serum levels (s‐TK), an indirect marker of proliferative activity, in myelodysplastic syndromes (MDS). S‐TK levels were monitored by means of a radioenzyme assay in 90 patients affected by MDS (22 refractory anaemia, RA; 17 RA with ring sideroblasts, RARS; 21 RA with blast excess, RAEB; 15 RAEB in transformation, RAEB‐T; 15 chronic myelomono‐cytic leukaemia, CMMoL). Mean s‐TK levels (U//tl) measured at diagnosis were 11–9 –12–6 for RA, 11–4–13′6 for RARS, 19–9 – 28–4 for RAEB, 39–6 – 34–3 for RAEB‐T and 77–7 – 69–7 for CMMoL (normal values <5U//LI1). With the only exception of a weak relationship with lactate dehydrogenase, no correlation was found between initial s‐TK values and other clinical or laboratory parameters, such as age, haemoglobin, white blood cell or platelet count, percentage of bone marrow blasts. MDS patients with s‐TK >38 V/fA , a cut‐off level selected by means of ROC statistical analysis, showed a significantly shorter survival than those with s‐TK <38U//xl (8–2 v 37–4 months, respectively; P < 0–0001). In particular, transformation in acute myeloid leukaemia (AML) occurred in 17/21 (81%) of patients with s‐TK >38U//d and 9/69 (13%) of those with lower levels at diagnosis (P < 00001), independently of FAB subtype. High s‐TK levels were also useful to predict evolution in AML during the course of the disease in patients with normal initial values. Multivariate analysis confirmed the independent prognostic value of s‐TK on both overall survival and risk of acute transformation. We conclude that s‐TK may be an important prognostic factor in MDS, strongly correlated with development of AML.