Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes

Leuk Res. 2015 Aug;39(8):846-52. doi: 10.1016/j.leukres.2015.05.007. Epub 2015 Jun 22.

Abstract

Background: Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders, with very different prognosis in given individuals; age and comorbidities are emerging as relevant patient-related factors influencing clinical outcome in MDS. Our aim was to evaluate the impact of age, comorbidities and disease severity (IPSS and IPSS-R prognostic scores) in a "real-life" series of MDS patients.

Methods: 318 patients with available assessment of comorbidities at diagnosis and consecutively registered into the Registro Ligure delle Mielodisplasie were analyzed. Comorbidities were evaluated according to HCT-CI and MDS-CI comorbidity indexes. Overall survival (OS) and the probability of death among patients who did not develop acute myeloid leukemia (NLD cumulative incidence) were analyzed.

Results: Comorbidities were seen in 177 (55.7%) patients. An older age (>75 y) had a significant negative impact on OS (p=0.008). HCT-CI was not associated with OS. MDS-CI was of prognostic significance (p=0.001), but the association was limited to pts with IPSS or IPSS-R "lower-risk". In multivariate analysis, MDS-CI remained an independent factor associated with OS and with an increased risk of NLD both when controlling for IPSS (p=0.019 and p=0.001, respectively) and for IPSS-R (p=0.048 and p=0.002, respectively).

Conclusions: Evaluation of age and comorbidities according to a tailored tool such is MDS-CI helps to predict survival in patients with MDS and should be incorporated to current prognostic scores.

Keywords: Comorbidity; Elderly; Myelodysplastic syndromes; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / diagnosis*
  • Myelodysplastic Syndromes / epidemiology*
  • Myelodysplastic Syndromes / mortality
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Survival Analysis