Factors affecting prognosis in myelodysplastic syndrome: an 11 years’ experience from a tertiary care center

Abstract

Aims: Myelodysplastic syndrome (MDS) is a clonal bone marrow neoplasia characterized by morphological findings of dysplasia in hematopoietic cells, peripheral cytopenia(s), ineffective hematopoiesis, recurrent genetic abnormalities, and an increased risk of conversion to acute myeloid leukemia (AML). The International Prognostic Scoring System (IPSS) is the most commonly used prognostic classification system for MDS. Classification was made by a combination of morphology, cytopenia, and genetic studies. In this study, we aimed to examine the parameters that affect prognosis in MDS patients, show their effects on mortality, and evaluate their positive or negative effects on the course of the disease. Methods: Two hundred twenty-nine patients who applied to Erciyes University Faculty of Medicine, Department of Hematology, and were diagnosed with MDS according to WHO classification between 2010 and 2020 were included in this retrospective study. Age, gender, additional disease status, laboratory parameters, bone marrow biopsy materials, and genetic mutation analysis data were available. The bone marrow aspiration and biopsy examinations of each patient were evaluated and categorized according to the WHO classification. The prognosis was evaluated according to the data of the patients, survival-exitus, and survival after MDS-AML conversion. Risk scoring was analyzed with three different scoring systems (IPSS, WPSS, and R-IPSS). Results: Of the 229 MDS patients included in the study, 57% (131) were male. The mean age of the patients was 67 years. Age, MDS-AML conversion times, disease duration, cellularity, and pathology blast rate were found to be statistically significant between the groups (p<0.05). Leukocyte, neutrophil, platelet, hematocrit, lymphocyte, monocyte, CRP, erythropoietin, ferritin, and LDH data were found to be statistically significant regarding survival (p<0.05). Age, IPSS risk status 3, and W-PSS risk status 3 were found to be independent risk factors affecting survival. Conclusion: Age, IPSS high risk, and WPSS high risk status were found to be independent risk factors affecting survival. Although our study revealed important data in the analysis of MDS patients, single-center analysis of patients and retrospective analysis revealed the need for further studies.