Abstract
Abstract 4940
Myelodysplastic syndrome (MDS) is a heterogeneous clonal hematopoietic cell disorder. The prognostic implication of comorbidities at diagnosis of MDS is emerging.
We aimed to investigate the impact of comorbidity on the patients with MDS.
Totally 263 MDS patients during a 15-year period in single institute were collected.
The clinical characteristics and the extra-hematological systemic diseases at diagnosis were all registered in this database. Well established prognostic models, including original International Prognostic Scoring System (IPSS), WHO classification-based Prognostic Scoring System (WPSS), and total MDACC scores were evaluated in our cohort.
Comorbidity was present in 76. 4% of patients. In univariate and multivariate analysis, HCT-CI ≥ 3 was significantly associated with poor outcome. IPSS, WPSS and MDACC were informative to discriminate between risk groups of patients with MDS. By comparing AIC values in the Cox proportional hazards analysis, MDACC had superior prognostic value followed by IPSS and WPSS. A modified score incorporating HCT-CI and MDACC divided patients into four risk groups. The 3 year-survival rate was 72%, 40%, 31%, 4%, respectively.
Building new models incorporating comorbidities to current prognostic score help to predict survival in patients with MDS.
. | Patient No. . | % . |
---|---|---|
Age, years | ||
¡Ø 65 | 65 | 24.7 |
¡Ö 65 | 198 | 75.3 |
Gender | ||
Male | 198 | 75.3 |
Female | 65 | 24.7 |
Comorbidity system | ||
Arrhythmia | 24 | 9.1 |
Cardiac | 65 | 24.7 |
Inflammatory bowel disease | 0 | 0 |
Diabetes | 72 | 27.4 |
Cerebrovascular disease | 15 | 5.7 |
Psychiatric disturbance | 7 | 2.7 |
Hepatic | 45 | 17.1 |
Obesity | 0 | 0 |
Infection | 47 | 17.9 |
Rheumatologic | 13 | 4.9 |
Peptic ulcer | 31 | 11.8 |
Renal | 12 | 4.6 |
Pulmonary | 33 | 12.5 |
Prior solid tumor | 35 | 13.3 |
Heart valve disease | 9 | 3.4 |
. | Patient No. . | % . |
---|---|---|
Age, years | ||
¡Ø 65 | 65 | 24.7 |
¡Ö 65 | 198 | 75.3 |
Gender | ||
Male | 198 | 75.3 |
Female | 65 | 24.7 |
Comorbidity system | ||
Arrhythmia | 24 | 9.1 |
Cardiac | 65 | 24.7 |
Inflammatory bowel disease | 0 | 0 |
Diabetes | 72 | 27.4 |
Cerebrovascular disease | 15 | 5.7 |
Psychiatric disturbance | 7 | 2.7 |
Hepatic | 45 | 17.1 |
Obesity | 0 | 0 |
Infection | 47 | 17.9 |
Rheumatologic | 13 | 4.9 |
Peptic ulcer | 31 | 11.8 |
Renal | 12 | 4.6 |
Pulmonary | 33 | 12.5 |
Prior solid tumor | 35 | 13.3 |
Heart valve disease | 9 | 3.4 |
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
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