Acta Oncol Tur.. 2023; 56(2): 114-124 | DOI: 10.5505/aot.2023.36693

Risk Factors Associated with Progression of Myelodysplastic Syndrome: 13 Years of Experience from a Single Center

Emine Gültürk
Department of Hematology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: We aimed to assess the accuracy of the most widely-accepted prognostic classification systems in patients with myelodysplastic syndromes (MDS), and to investigate various parameters with respect to their association with MDS progression.
METHODS: Fifty-five patients diagnosed with MDS (January 1999 to December 2012) were reviewed retrospectively. Demographic characteristics, comorbidities, laboratory and pathological results, risk classifications (pathological and prognostic) at MDS diagnosis, treatment features, data regarding patient survival, and acute myeloid leukemia (AML) conversion were examined.
RESULTS: Thirty-five male and 20 female patients (mean age: 70.95±9.80 years) were included. Twenty-four (43.46%) patients were defined to have had progression. Having an ECOG-PS score of ≥2 (OR: 6.939, 95% CI: 1.527-31.526; p=0.012) and being classified as ‘high’ or ‘very high’ risk according to the WPSS (OR: 10.115, 95% CI: 2.293-44.614; p=0.002) were found to be the only factors independently associated with MDS progression.
DISCUSSION AND CONCLUSION: Although univariate differences were observed for various parameters, MDS progression was independently associated with ECOG-PS and WPSS class. It appears that singular classification systems are insufficient to predict MDS progression.

Keywords: Myelodysplastic syndrome, progression, prognostic factors, prognostic classification systems

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Miyelodisplastik Sendromun Progresyonu ile Ýliþkili Risk Faktörleri: Tek Merkezden 13 Yýllýk Deneyim

Emine Gültürk
Ýstanbul Bakýrköy Dr. Sadi Konuk Eðitim Araþtýrma Hastanesi, Hematoloji Bilim Dalý, Ýstanbul

GÝRÝÞ ve AMAÇ: Miyelodisplastik sendrom (MDS) tanýlý hastalarda en yaygýn olarak kabul edilen prognostik sýnýflandýrma sistemlerinin doðruluðunu deðerlendirmeyi ve MDS progresyonu ile iliþkisine göre çeþitli parametreleri araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: MDS tanýsý konan 55 hasta (Ocak 1999-Aralýk 2012) geriye dönük olarak incelendi. Demografik özellikler, komorbiditeler, laboratuvar ve patolojik sonuçlar, MDS tanýsýnda risk sýnýflamalarý (patolojik ve prognostik), tedavi özellikleri, hasta saðkalýmý ile ilgili veriler ve akut miyeloid lösemi (AML) dönüþümü incelendi.
BULGULAR: Otuz beþ erkek ve 20 kadýn hasta (ortalama yaþ: 70.95±9.80 yýl) dahil edildi. Yirmi dört (%43.46) hastada progresyon olduðu belirlendi. Sadece ECOG-PS skorunun ≥2 olmasý (OR: 6.939, %95 GA: 1.527-31.526; p=0.012) ve WPSS'ye göre 'yüksek' veya 'çok yüksek' riskli olarak sýnýflandýrmanýn (OR: 10.115, %95) GA: 2.293-44.614; p=0.002), MDS progresyonu ile baðýmsýz olarak iliþkili faktörler olduðu belirlendi.
TARTIÞMA ve SONUÇ: Çeþitli parametreler için tek deðiþkenli farklýlýklar gözlemlenmesine raðmen, MDS progresyonu baðýmsýz olarak ECOG-PS ve WPSS sýnýflandýrmasý ile iliþkilendirilmiþtir. Sýnýflandýrma sistemlerinin tek baþýna MDS progresyonunu tahmin etmede yetersiz olduðu görülmektedir.

Anahtar Kelimeler: Miyelodisplastik sendrom, progresyon, prognostik faktörler, prognostik sýnýflandýrma sistemleri

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