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Newer cytogenetic scoring systems for myelodysplastic syndromes (MDSs), like cytogenetic stratification of the revised international prognostic scoring system (IPSS-R) or monosomal karyotype, may also improve outcome prediction after hematopoietic SCT (HCT). We compared the prognostic value of specific cytogenetic abnormalities, IPSS-R karyotype and monosomal karyotype for HCT outcome in 98 patients with MDS and AML post MDS. Higher-risk IPSS-R karyotype, 3q21q26 and transformation to AML before HCT were associated with increased cumulative incidence of relapse (CIR), whereas OS was adversely influenced by del 5q/−5, abnormalities of chromosomes 11 and 17 and cytogenetic IPSS-R very poor category. Karyotype with ⩽2 abnormalities and no abnormalities of chromosomes 3, 5, 7, 11 and 17 was an independent prognostic factor of lower CIR (hazard ratio (HR)=0.2, P=0.01) and longer OS (HR=0.5, P=0.03). In conclusion, some specific cytogenetic abnormalities and high cytogenetic complexity, as reflected by IPSS-R very poor karyotype, rather than monosomal karyotype, were associated with higher CIR and shorter OS after HCT. Conversely, results were encouraging in patients lacking those abnormalities, who may be very good candidates for HCT. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to evaluate comparatively the effectiveness of a conservative approach to treatment, using two therapeutic schedules (with and without sodium thiosulfate (ST), so as to minimize necrosis due to drug extravasation and to avoid the need for reconstructive surgery. The 63 patients entered into this study were separated into two groups; these in group A were treated with hydrocortisone and dexamethasone, and these in group B received the combination plus ST. In both groups, the drugs that had extravasated included doxorubicin, epirubicin, vinblastine, mitomycin C. The healing time varied with the different drugs used and was proportional to the extent of extravasation and to the time at which therapy was begun. The mean healing time for group B, which received ST was about half that for group A, which did not. We conclude that the application of conservative measures during chemotherapy may prevent tissue necrosis due to drug extravasation and the subsequent need for reconstructive surgery. The administration of ST can help in the achievement of this goal. [ABSTRACT FROM AUTHOR]