Prospective analysis of clinical and cytogenetic features of 435 cases of MDS diagnosed using the WHO (2001) classification: a prognostic scoring system for predicting survival in RCMD |
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| Authors: | Xiao Qin Wang John Ryder Sherilyn A Gross Guowei Lin " target="_blank">Richard D Irons |
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| Institution: | (1) Fudan-Cinpathogen Clinical and Molecular Research Center (CMRC), Institute of Biomedical Sciences, Fudan University, Shanghai, China;(2) Huashan Hospital, Fudan University, Shanghai, China;(3) Department of Pathology, School of Medicine, University of Colorado Denver, Colorado, USA;(4) Department of Pharmaceutical Sciences, School of Pharmacy, University of Colorado Denver, Colorado, USA;(5) Department of Pathology, Fudan University, Shanghai, China;(6) Cinpathogen, Inc, Boulder, USA;(7) Cinpathogen, Inc, Shanghai, China;(8) Central Laboratory, Fudan-Cinpathogen Clinical and Molecular Research Center, 1st Floor, No. 5 Building, 399 Cai Lun Road, Zhanjiang, Shanghai, 201210, China; |
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| Abstract: | We characterized the prevalence, clinical and cytogenetic characteristics and survival of 435 patients diagnosed with de novo
MDS in a single laboratory according to WHO criteria, and compared the utility of different scoring systems to predict survival
for individual subtypes of MDS. The mean follow-up period was 25.1 (5.5–53.2) months. Our results confirm major differences
in the age-distribution and prevalence of individual subtypes of MDS between Asian and Western patients with a median age
of 58 years and a predominance of RCMD (69.9%). Survival rates were similar to those reported in the West: the 3-year survival
rate for MDS was 46.7% with a median survival time for RCMD of 38 months and RAEB, 10 months. We found that the IPSS and WPSS
scoring systems, which are weighted heavily by blast cell count and karyotype, were not independent predictors for survival
in RCMD patients. Multivariate analysis demonstrated that a scoring system based on age (≥60 years), ANC (<1.0 × 109/L), Hb (<90 g/L), number of cytopenias and complex karyotype is a more useful predictor of survival in RCMD. |
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