Comparison of clinical and laboratory features among three risk groups based on the immune cell scoring system
| Clinical characters . | Total (N = 316) . | Low risk (n = 182) . | Intermediate risk (n = 111) . | High risk (n = 23) . | P value . |
|---|---|---|---|---|---|
| Sex | .784 | ||||
| Female | 113 (35.8) | 67 (36.8) | 37 (33.3) | 9 (39.1) | |
| Male | 203 (64.2) | 115 (63.2) | 74 (66.7) | 14 (60.9) | |
| Age* | 68.5 (18-94) | 68.1 (22-94) | 69.3 (18-93) | 65.8 (20-85) | .228 |
| Laboratory data* | |||||
| WBC, × 109/L | 3.7 (0.5-54.4) | 3.8 (0.5-52.6) | 3.8 (0.8-54.4) | 3.0 (0.8-15.8) | .317 |
| ANC, × 109/L | 1.71 (0.1-37.1) | 2.0 (0.1-37.1) | 1.5 (0.1-32.3) | 0.9 (0.1-7.2) | .094 |
| Hb, g/dL | 8.4 (4-17) | 8.3 (4-17) | 8.4 (4-15) | 8.5 (6-12) | .662 |
| Platelet, × 109/L | 82 (1-721) | 79 (3-417) | 87 (1-721) | 68 (2-230) | .305 |
| BM blast (%) | 6 (0-19) | 3.8 (0-16) | 9.0 (0.4-18) | 10 (0-19) | <.001 |
| PB blast (%) | 0 (0-18) | 0 (0-16) | 1 (0-16) | 1 (0-18) | <.001 |
| 2016 WHO classification | |||||
| MDS-SLD | 32 (10.1) | 26 (14.3) | 6 (5.4) | 0 (0) | .012 |
| MDS-MLD | 49 (15.5) | 31 (17.0) | 15 (13.5) | 3 (13.0) | .682 |
| MDS-RS | 25 (7.9) | 17 (9.3) | 7 (6.3) | 1 (4.3) | .521 |
| MDS-RS-MLD | 24 (7.6) | 20 (11) | 4 (3.6) | 0 (0) | .025 |
| MDS-U | 5 (1.6) | 4 (2.2) | 1 (0.9) | 0 (0) | .565 |
| MDS-EB1 | 73 (23.1) | 39 (21.4) | 26 (23.4) | 8 (34.8) | .357 |
| MDS-EB2 | 108 (34.2) | 45 (24.7) | 52 (46.8) | 11 (47.8) | <.001 |
| IPSS-R†,‡ | |||||
| Very low | 11 (3.6) | 10 (5.7) | 1 (0.9) | 0 (0) | .064 |
| Low | 74 (24.1) | 50 (28.7) | 22 (19.8) | 2 (9.1) | .053 |
| Intermediate | 69 (22.5) | 42 (24.1) | 22 (19.8) | 5 (22.7) | .696 |
| High | 75 (24.4) | 40 (23.0) | 32 (28.8) | 3 (13.6) | .253 |
| Very high | 78 (25.4) | 32 (18.4) | 34 (30.6) | 12 (54.5) | <.001 |
| Treatment | |||||
| Supportive care | 162 (51.3) | 108 (59.3) | 45 (40.5) | 9 (39.1) | .004 |
| Active treatment§ | |||||
| HMA | 115 (36.4) | 56 (30.8) | 49 (44.1) | 10 (43.5) | .053 |
| LDAraC¶ | 30 (9.5) | 12 (6.6) | 14 (12.6) | 4 (17.4) | .095 |
| Intensive chemotherapy | 28 (8.9) | 13 (7.1) | 13 (11.7) | 2 (8.7) | .410 |
| HSCT | 47 (14.9) | 26 (14.3) | 15 (13.5) | 6 (26.1) | .287 |
| Clinical characters . | Total (N = 316) . | Low risk (n = 182) . | Intermediate risk (n = 111) . | High risk (n = 23) . | P value . |
|---|---|---|---|---|---|
| Sex | .784 | ||||
| Female | 113 (35.8) | 67 (36.8) | 37 (33.3) | 9 (39.1) | |
| Male | 203 (64.2) | 115 (63.2) | 74 (66.7) | 14 (60.9) | |
| Age* | 68.5 (18-94) | 68.1 (22-94) | 69.3 (18-93) | 65.8 (20-85) | .228 |
| Laboratory data* | |||||
| WBC, × 109/L | 3.7 (0.5-54.4) | 3.8 (0.5-52.6) | 3.8 (0.8-54.4) | 3.0 (0.8-15.8) | .317 |
| ANC, × 109/L | 1.71 (0.1-37.1) | 2.0 (0.1-37.1) | 1.5 (0.1-32.3) | 0.9 (0.1-7.2) | .094 |
| Hb, g/dL | 8.4 (4-17) | 8.3 (4-17) | 8.4 (4-15) | 8.5 (6-12) | .662 |
| Platelet, × 109/L | 82 (1-721) | 79 (3-417) | 87 (1-721) | 68 (2-230) | .305 |
| BM blast (%) | 6 (0-19) | 3.8 (0-16) | 9.0 (0.4-18) | 10 (0-19) | <.001 |
| PB blast (%) | 0 (0-18) | 0 (0-16) | 1 (0-16) | 1 (0-18) | <.001 |
| 2016 WHO classification | |||||
| MDS-SLD | 32 (10.1) | 26 (14.3) | 6 (5.4) | 0 (0) | .012 |
| MDS-MLD | 49 (15.5) | 31 (17.0) | 15 (13.5) | 3 (13.0) | .682 |
| MDS-RS | 25 (7.9) | 17 (9.3) | 7 (6.3) | 1 (4.3) | .521 |
| MDS-RS-MLD | 24 (7.6) | 20 (11) | 4 (3.6) | 0 (0) | .025 |
| MDS-U | 5 (1.6) | 4 (2.2) | 1 (0.9) | 0 (0) | .565 |
| MDS-EB1 | 73 (23.1) | 39 (21.4) | 26 (23.4) | 8 (34.8) | .357 |
| MDS-EB2 | 108 (34.2) | 45 (24.7) | 52 (46.8) | 11 (47.8) | <.001 |
| IPSS-R†,‡ | |||||
| Very low | 11 (3.6) | 10 (5.7) | 1 (0.9) | 0 (0) | .064 |
| Low | 74 (24.1) | 50 (28.7) | 22 (19.8) | 2 (9.1) | .053 |
| Intermediate | 69 (22.5) | 42 (24.1) | 22 (19.8) | 5 (22.7) | .696 |
| High | 75 (24.4) | 40 (23.0) | 32 (28.8) | 3 (13.6) | .253 |
| Very high | 78 (25.4) | 32 (18.4) | 34 (30.6) | 12 (54.5) | <.001 |
| Treatment | |||||
| Supportive care | 162 (51.3) | 108 (59.3) | 45 (40.5) | 9 (39.1) | .004 |
| Active treatment§ | |||||
| HMA | 115 (36.4) | 56 (30.8) | 49 (44.1) | 10 (43.5) | .053 |
| LDAraC¶ | 30 (9.5) | 12 (6.6) | 14 (12.6) | 4 (17.4) | .095 |
| Intensive chemotherapy | 28 (8.9) | 13 (7.1) | 13 (11.7) | 2 (8.7) | .410 |
| HSCT | 47 (14.9) | 26 (14.3) | 15 (13.5) | 6 (26.1) | .287 |
P values of <.05 are statistically significant.
ANC, absolute neutrophil count; Hb, hemoglobin; LDAraC: low-dose cytarabine; MDS-EB, MDS with excess blasts; MDS-MLD, MDS with multilineage dysplasia; MDS-RS, MDS with ring sideroblasts; MDS-SLD, MDS with single lineage dysplasia; MDS-RS-SLD, MDS with ring sideroblasts and single lineage dysplasia; MDS-RS-MLD, MDS with ring sideroblasts and multilineage dysplasia; MDS-U, MDS, unclassifiable.
Median (range).
307 patients had chromosome data at diagnosis.
IPSS-R: very low, ≤1.5; low, >1.5 to 3; intermediate (INT), >3 to 4.5; high, >4.5 to 6; very high, >6.
Active treatment includes HMA, LDAraC, high-intensity chemotherapy, and HSCT. Some patients received more than 1 treatment modality: 15 received HMA and LDAraC; 8 received HMA and high-intensity chemotherapy; 6 received LDAraC and high-intensity chemotherapy; 1 received LDAraC and HSCT; 2 received high-intensity chemotherapy and HSCT; 28 received HMA and HSCT; 3 received HMA, high-intensity chemotherapy, and HSCT; and 13 received HSCT without bridging therapy.
Low-dose cytarabine at 20 mg once or twice daily for 10 consecutive days every 4 to 6 weeks.