Volumen: 20 # Number : 1
Publication Date : Enero - Abril Year: 2016
Epidemiological and prognostic
features of patients with myelodisplastic syndromes (MDS) from
the Argentinean Registry
Authors: Flores G., Basquiera A. L., Kornblihtt L.,
Sackmann F., Prates V., Schutz N., Viñuales E., Fantl D.,
Cárdenas M. P., Benasayag S., Crisp R., Pintos N.,Santos I., Iastrebner M., Belli C.
Abstract: MDS are a heterogeneous group of clonal disorders
with variable clinical course ranging from stable disease
to death within months due to leukemic transformation
or cytopenias related complications. This
variability complicates decision-making regarding
therapies, and prognostic characterization is vital
prior initiating treatment. The International Prognostic
Scoring System (IPSS), which has been widely
adopted, was revised (IPSS-R) in 2012, redefining
cytogenetic groups, cut-off for cytopenias and bone
marrow (BM) blasts. They exclude secondary MDS
and myeloproliferative- chronic myelomonocytic
leukemia, included in the MD Anderson (MDA)
system. Other disease and patient related factors are
on debate. Argentinean MDS Registry was created
in 2008 and 17 institutions have been reporting data
from 532 patients (89% with de novo MDS).Since
descriptive studies are necessary to establish epidemiological
features and to validate prognosis factors and scoring systems to properly adapt therapeutic
schemes useful for public health strategies, the aim
of this work was to evaluate our population-based
registry. The median age was 72 (17-95) years with
a gender ratio (M/F) of 1.3. During the follow-up
(median: 18 months), 104 (19.5%) patients evolved
to AML and 211 (39.7%) died. Age, gender, percentage
of BM blast, hemoglobin level, platelet and
neutrophil counts, cytogenetic groups of risk, LDH,
and presence of myelofibrosis were significant predictive
variables for prognosis. FAB and WHO
classifications, and scoring systems (IPSS, IPSS-R,
WPSS according to hemoglobin levels, MDA score,
and Charlson’s Comorbidities Index) allowed us to
differentiate groups with different outcomes (Kaplan-
Meier and Long-Rank test, p<0.05).Our data
confirmed previous published data regarding prognostic
variables in our population.
Key words: Myelodisplastic Syndromes,
Prognosis,
Argentinean Registry of Hematologic diseases
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