Objective: To investigate the prognostic value of a modified WPSS based on routine laboratory parameters in Chinese patients with myelodysplastic syndromes (MDS).
Methods: One hundred and sixty four adult MDS patients were retrospectively analyzed.
Results: The median follow-up time was 19 (1-138) months and the median survival (MS) was 36 months. 2-year prospective survival (PS) was 60% and 5-year PS was 42%. In patients with very low-risk, low-risk, intermediate-risk, high-risk and very high-risk stratified by WPSS, 2-year PS was 100%, 96%, 81%, 38% and 14%, and 5-year PS was 100%, 83%, 54%, 20% and 0, respectively (P<0.01). Among parameters of laboratory routine examination, elevated mean cell volume (MCV), mean cell hemoglobin (MCH), neutrophil alkaline phosphatase (N-ALP) index and nucleated RBC PAS negative were good prognostic factors, while reduced Hb, BPC and bone marrow elevated blasts, dysplasia more than 1 lineage, and lymphocyte-like micromegakaryocyte (MEGly) as well as elevated serum LDH were poor prognostic factors in uni-variable analysis. Among them, MCV, MEGly and blast had independent prognostic significance in multi-variable analysis (P = 0.011, 0.013 and 0.016, respectively). WPSS was modified by omitting chromosomal karyotype and transfusion dependence and adding MCV and MEGly. In patients with low-risk, intermediate-risk and high-risk stratified by modified WPSS, 2-year PS was 94%, 68% and 49%, respectively; and 5-year PS was 86%, 53% and 14%, respectively (P<0.01).
Conclusion: The modified WPSS worked well for prognostic prediction in Chinese patients with MDS.