The clinical implication of SRSF2 mutation in patients with myelodysplastic syndrome and its stability during disease evolution.

Recurrent somatic mutation of SRSF2, one of the RNA splicing machinery genes, has been identified in a substantial pro-portion of patients with myelodysplastic syndrome (MDS). However, the clinical and biologic characteristics of MDS with this mutation remain to be addressed. In this study, 34 (14.6%) of the 233 MDS patients were found to have SRSF2 muta-tion. SRSF2 mutation was closely associ-ated with male sex (P = .001) and older age (P < .001). It occurred concurrently with at least 1 additional mutation in 29 patients (85.3%) and was closely asso-ciated with RUNX1, IDH2, and ASXL1 mu-tations (P = .004, P < .001, and P < .001, respectively). Patients with SRSF2 muta-tion had an inferior overall survival (P=.010), especially in the lower risk patients. Further exploration showed that the prognostic impact of SRSF2 mutation might be attributed to its close associa-tion with old age. Sequential analyses in 173 samples from 66 patients showed that all SfiSF2-mutated patients retained their original mutations, whereas none of the SRSF2-wild patients acquired a novel mutation during disease evolution. In conclusion, SRSF2 mutation is associ-ated with distinct clinical and biologic features in MDS patients. It is stable during the clinical course and may play little role in disease progression. [ABSTRACT FROM AUTHOR]