The MDS Beacon™

Scientists have found that the prognosis of a subset of myelodysplastic syndromes (MDS) patients may be affected by activation of the gene RPS14. Low levels of activation of this gene were linked to prolonged survival in patients with intermediate-1 risk MDS and without deletion 5q syndrome. The scientists at Heinrich-Heine-University in Dusseldorf, Germany published their findings in the journal Haematologica.

Patients missing part of chromosome 5, which is known as deletion 5q syndrome, have a better prognosis than most other MDS patients (related Beacon news). Studies have also shown that MDS patients with the chromosome 5 deletion have decreased activation of the gene RPS14.

Therefore, the purpose of this study was to investigate whether RPS14 activation correlates with survival in MDS patients without the chromosome 5 deletion. In this study, researchers examined RPS14 activation levels in 72 non-deletion 5q MDS patients, 9 deletion 5q MDS patients, and 11 healthy patients.

Among the MDS patients without the chromosome 5 abnormality, 71 percent had decreased activation of RPS14 compared to healthy patients.

The decreased activation of RPS14 had significant survival benefit in patients with intermediate-1 risk MDS. Patients in this risk group with low gene activation had not yet reached the median overall survival after 40 months of follow-up. Their survival was significantly longer than patients in the same risk group with high gene activation, who had a median survival of 25 months.

However, Dr. Akos Czibere, lead author of the study, said, “The improved survival rate described in our study counted only for patients with MDS and an intermediate risk-1 score.” Activation levels of RPS14 did not impact survival for patients with advanced MDS.

According to the researchers, these results indicate that patients with low RPS14 activation and an intermediate-1 risk score may form a distinct group of MDS patients with superior survival.

The authors explained that patients who respond to Revlimid (lenalidomide) treatment have certain irregularities in their DNA caused by loss of RPS14 activation. Thus, the authors suggest that RPS14 activation levels may be useful in identifying which intermediate-1 risk MDS patients are likely to respond positively to Revlimid treatment.

“Prospective clinical studies testing this hypothesis are needed before definitive treatment decisions based on the RPS14 [activation] level can be made,” said Czibere.

Czibere also added, “Our finding may indeed have an impact on the future treatment of [MDS] patients, especially on those patients with intermediate-1 risk and normal RPS14 [activation], who may need a more aggressive treatment at an earlier time of the disease course.”

For more information, please see the study in the October issue of Haematologica.