Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes.

Abstract:

BACKGROUND:Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders, with very different prognosis in given individuals; age and comorbidities are emerging as relevant patient-related factors influencing clinical outcome in MDS. Our aim was to evaluate the impact of age, comorbidities and disease severity (IPSS and IPSS-R prognostic scores) in a "real-life" series of MDS patients. METHODS:318 patients with available assessment of comorbidities at diagnosis and consecutively registered into the Registro Ligure delle Mielodisplasie were analyzed. Comorbidities were evaluated according to HCT-CI and MDS-CI comorbidity indexes. Overall survival (OS) and the probability of death among patients who did not develop acute myeloid leukemia (NLD cumulative incidence) were analyzed. RESULTS:Comorbidities were seen in 177 (55.7%) patients. An older age (>75 y) had a significant negative impact on OS (p=0.008). HCT-CI was not associated with OS. MDS-CI was of prognostic significance (p=0.001), but the association was limited to pts with IPSS or IPSS-R "lower-risk". In multivariate analysis, MDS-CI remained an independent factor associated with OS and with an increased risk of NLD both when controlling for IPSS (p=0.019 and p=0.001, respectively) and for IPSS-R (p=0.048 and p=0.002, respectively). CONCLUSIONS:Evaluation of age and comorbidities according to a tailored tool such is MDS-CI helps to predict survival in patients with MDS and should be incorporated to current prognostic scores.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Balleari E,Salvetti C,Del Corso L,Filiberti R,Bacigalupo A,Bellodi A,Beltrami G,Bergamaschi M,Berisso G,Calzamiglia T,Carella AM,Cavalleri M,Da Col A,Favorini S,Forni GL,Goretti R,Miglino M,Mitscheuning L,Molinari E,

doi

10.1016/j.leukres.2015.05.007

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

846-52

issue

8

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(15)00151-4

journal_volume

39

pub_type

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