Baseline characteristics and predictors of outcome in patients with myelodysplastic syndromes living in Western Pennsylvania

Abstract

The myelodysplastic syndromes (MDS) are a collection of hematologic disorders that affect older adults, and whose baseline characteristics and risk factors for evolution to acute myeloid leukemia (AML) and death have not been completely defined. We analyzed a large unselected cohort of 214 patients with MDS from the University of Pittsburgh Network Cancer Registry in Western Pennsylvania. Patients' follow-up was 22 months, at the end of which 72.9% of patients were dead. Overall, the 36-month survival rate was 19.0% (95% CI: 14.0–24.5%); 22.4% (95% CI: 16.4–29.0%) for patients with lower-risk MDS; and 5.0% (95% CI: 0.1–14.8%) for patients with higher-risk MDS (p = 0.0007). During follow-up, 32.9% of the patients developed AML. Family history of cancer and having ≥5% blasts at diagnosis were statistically significant predictors for progression to AML. A higher risk of death also was associated with age >70 years and previous diagnosis of another cancer. More than three cycles of chemotherapy sessions and a platelet count of ≥50 × 10³/mm³ were inversely associated with death. This study suggests the need to incorporate laboratory results such as percentage blasts and platelet counts as well as epidemiologic data on family history of cancer in future outcome studies on MDS.

Keywords:

• MDS
• Bone marrow failure
• Epidemiology
• Cancer registry

Acknowledgements

We thank Sharon Winters for access to the cancer registry data, and Stacy Eckstein for data entry and data quality control.

Declaration of interest: Funding for this work was supported in part by a grant from AMGEN Inc.; AMGEN is a manufacturer of drugs used for the therapy of hematological conditions. Jon Fryzek and Mellissa Yong were employed by AMGEN at the time this work was conducted and both own stock in AMGEN.