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Cytogenetic and molecular aberrations and worse outcome for male patients in systemic mastocytosis

Hanneke C. Kluin-Nelemans*, Mohamad Jawhar, Andreas Reiter, Bjorn van Anrooij, Jason Gotlib, Karin Hartmann, Anja Illerhaus, Hanneke N.G. Oude Elberink, Aleksandra Gorska, Marek Niedoszytko, Magdalena Lange, Luigi Scaffidi, Roberta Zanotti, Patrizia Bonadonna, Cecelia Perkins, Chiara Elena, Luca Malcovati, Khalid Shoumariyeh, Nikolas von Bubnoff, Sabine MüllerMassimo Triggiani, Roberta Parente, Juliana Schwaab, Michael Kundi, Anna Belloni Fortina, Francesca Caroppo, Knut Brockow, Alexander Zink, David Fuchs, Irena Angelova-Fischer, Akif Selim Yavuz, Michael Doubek, Mattias Mattsson, Hans Hagglund, Jens Panse, Anne Simonowski, Vito Sabato, Tanja Schug, Madlen Jentzsch, Christine Breynaert, Judit Várkonyi, Vanessa Kennedy, Olivier Hermine, Julien Rossignol, Michel Arock, Peter Valent, Wolfgang R. Sperr

*Korrespondierende/r Autor/-in für diese Arbeit

Abstract

In systemic mastocytosis (SM), the clinical features and survival vary greatly. Patient-related factors determining the outcome in SM are largely unknown. Methods: We examined the impact of sex on the clinical features, progression-free survival (PFS), and overall survival (OS) in 3403 patients with mastocytosis collected in the registry of the European Competence Network on Mastocytosis (ECNM). The impact of cytogenetic and molecular genetic aberrations on sex differences was analyzed in a subset of patients. Results: Of all patients enrolled, 55.3% were females. However, a male predominance was found in a subset of advanced SM (AdvSM) patients, namely SM with an associated hematologic neoplasm (SM-AHN, 70%; p < 0.001). Correspondingly, organomegaly (male: 23% vs. female: 13%, p = 0.007) was more, whereas skin involvement (male: 71% vs. female: 86%, p = 0.001) was less frequent in males. In all patients together, OS (p < 0.0001) was significantly inferior in males, and also within the WHO sub-categories indolent SM, aggressive SM (ASM) and SM-AHN. PFS was significantly (p = 0.0002) worse in males when all patients were grouped together; due to low numbers of events, this significance persisted only in the subcategory smoldering SM. Finally, prognostically relevant cytogenetic abnormalities (10% vs. 5%, p = 0.006) or molecular aberrations (SRSF2/ASXL1/RUNX1 profile; 63% vs. 40%, p = 0.003) were more frequently present in males. Conclusions: Male sex has a major impact on clinical features, disease progression, and survival in mastocytosis. Male patients have an inferior survival, which seems related to the fact that they more frequently develop a multi-mutated AdvSM associated with a high-risk molecular background.

OriginalspracheEnglisch
ZeitschriftTheranostics
Jahrgang11
Ausgabenummer1
Seiten (von - bis)292-303
Seitenumfang12
ISSN1838-7640
DOIs
PublikationsstatusVeröffentlicht - 2020

Fördermittel

This work was supported by the Austrian Science Fund (FWF), SFB grants F4701-B28, F4704-B28, and P32470-B (to P.V.), by the ‘Charles and Ann Johnson Foundation’ (to J.G.). V.S. is a Senior Clinical Researcher of the Research Foundation Flanders/Fonds Wetenschappelijk Onderzoek (FWO: 1804518N). C.B. is supported by the Clinical Research Fund of the University Hospital Leuven. Hanneke C. Kluin-Nelemans: institutional financial support from Novartis; honoraria from Novartis for participating in e-learning program. Andreas Reiter: Novartis Pharma – research support, advisory board, honoraria, travel reimbursement, Blueprint Medicines - advisory board, honoraria, travel reimbursement, Deciphera – advisory board, travel reimbursement. Bjorn van Anrooij: financial support from Novartis for research and advisory boards. Jason Gotlib: Funding to support conduct of clinical trial: Blueprint Medicines, Deciphera; advisory board/honoraria: Blueprint Medicines, Deciphera, Allakos. Karin Hartmann: advisory board/honoraria: Allergopharma, ALK-Abelló, Blueprint, Deciphera, Menarini, Novartis and Takeda; research grant: Euroimmun. Hanneke Oude Elberink: honoraria from ALK-Abelló, Chiesi, MEDA Pharma, Novartis, and Blueprint. Magdalena Lange: honoraria from Novartis for lectures. Chiara Elena: advisory board Novartis, Pfizer. David Fuchs, Julien Rossignol: advisory board Novartis. Khalid Shoumariyeh: travel support from Abbvie and consultancy fees from Novartis. Nikolas von Bubnoff: institutional financial support from Novartis. Massimo Triggiani: advisory board BluePrint Medicines, Deciphera, Novartis. Akif SelimYavuz: honoraria from Novartis. Jens Panse: funding to support conduct of clinical trial: Blueprint Medicines, Deciphera; advisory board/honoraria: Blueprint Medicines, Novartis. Vito Sabato: advisory board/honoraria: Blueprint Medicines, Novartis. Madlen Jentzsch: honoraria from Novartis. Olivier Hermine: Research funding support from AB science and Novartis. Advisory board of AB science. Wolfgang R. Sperr: honoraria from Novartis, Pfizer, AbbVie, Daiichi Sankyo, Amgen, Thermo Fisher, Deciphera, Incyte, Celgene and Jazz. Michel Arock: advisory board/honoraria Blueprint Medicines, Deciphera. All other authors: none.

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

  1. SDG 3 – Gesundheit und Wohlergehen
    SDG 3 – Gesundheit und Wohlergehen

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