Abstract 4940

Introduction

Myelodysplastic syndrome (MDS) is a heterogeneous clonal hematopoietic cell disorder. The prognostic implication of comorbidities at diagnosis of MDS is emerging.

Objective

We aimed to investigate the impact of comorbidity on the patients with MDS.

Method

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.

Results

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.

Conclusion

Building new models incorporating comorbidities to current prognostic score help to predict survival in patients with MDS.

Table:

Patients baseline characteristics and comorbidities

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 
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Disclosures:

No relevant conflicts of interest to declare.

Topics:
comorbidity, myelodysplastic syndrome, obesity, prostatic hypertrophy risk score, cardiac arrhythmia, cerebrovascular disorders, diabetes mellitus, diabetes mellitus, type 2, heart valve diseases, infections

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2012 by The American Society of Hematology
2012
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