Biological follow up of MDS/AML patients before and after allogeneic stem cell transplantation (ASCT)

Abstract

Background: The diagnosis of AML and MDS is facilitated with biomolecular technology advancement which allowed the identification of several mutations. but, there is a need to develop tools and strategies to help the clinicians in interpreting the sequencing results.
Aims: The objectives of this study were first to construct a core database that combines qualitative and quantitative data of MDS/AML patients followed at CHU UCL Namur between November 2011 and November 2018. The second objective was to use the database to establish descriptive epidemiology of MDS and AML. And finally use the database to establish links between the biological parameters( WBC, PLT, LDH, and glycemia) and the cytogenetic and molecular biology parameters by addressing the challenges of the clinic issue of aplasia duration in AML patients.
Methods: Data of 80 patients MDS and AML were retrospectively used to set up the database: quantitative biological data were extracted from GLIMS laboratory software and qualitative data were collected from OMNIPRO clinical software. Excel software was used to set up the core database bringing together the quantitative (Biological data) and qualitative parameters (Demographic, Cytogenetic and molecular data) of MDS and AML patients. Subsequently, the data were described and represented with tables and diagrams.
Results: The core database consisted of 24 MDS and 56 AML patients. In MDS patients, the mean age was 63.91±12.61, and the Sex ratio male to female was 3,8:1. In AML patients, the mean age was 57.52±13.1 and the sex ratio male to female was 1.44:1. Among the 24 MDS patients, 10 mutations were identified and 11 chromosomal aberrations. Trisomy 8 was the most expressed chromosomal abnormality in MDS patients. In AML, NMP1 and FLT3 mutations were the most widely distributed. The 5q deletion and trisomy 8 were the most prevalent chromosomal abnormalities in AML patients. It was found that the average Aplasia duration of AML patients treated with Aracytin and Idarubicin in induction chemotherapy is 23 days. The link between the target biologicals parameters and the qualitative data was not established due to patients heterogeneity. Nevertheless, it was observed that in patients with 26 days of aplasia duration, relapse appears to reduce the survival of AML patients. In patients without the relapse event, death has been recorded at 12 months after allograft while in patients who died with relapse event, death has been recorded at 6 months after allograft
Conclusion: This work demonstrated that hospital databases contain a lot of useful information that is not sufficiently exploited. Set up a database that puts together all patients' data categories will enhance their exploitation

Date of Award	26 Aug 2019
Original language	English
Awarding Institution	University of Namur
Supervisor	Francois Mullier (Supervisor) & Hugues Jacqmin (Co-Supervisor)