Keywords
Myelodysplastic Syndrome
prognosis
RAEH
How to Cite
Abstract
Myelofibrosis (MF) is observed in 10-20% of patients with myelodysplastic syndrome (MDS). The presence of MF has been recognized as an adverse histological finding associated with an aggressive course including early bone marrow (BM) failure, shortened survival and leukemic evolution. The aim of this study was to examine the influence of the myelofibrosis (MF ≥1) in the overall survival (OS) and its association with clinical and histopathologic variables. We identified 468 MDS patients who were included in the Argentinian Registry of MDS from 2007 to 2017. The median OS for the MF≥1 subgroup was 20.1 months (95% CI 10.1-30.0) versus 67.6 months (95% CI 45.1-90.3) for the MF-0 subgroup (p<0.001). Cox regression analysis revealed that MF ≥1 (HR 1.46, 95% CI 1.06-2.03; p=0.020), performance status >2 (HR 2.07, 95% CI 1.44-2.96; p<0.001), hemoglobin level <10 gr/dL (HR 1.64, 95% CI 1.16-2.32; p=0.005), platelet counts <100,000/μL (HR 1.94, 95% CI 1.42-2.65; p<0.001), poor karyotypes (HR 1.86, 95% CI 1.32-2.63; p<0.001), BM blasts >5% (HR 2.94, 95% CI 2.06-4.20; p<0.001) and Charlson’s Comorbidity Index >3 (HR 2.17, 95% CI 1.48- 3.19; p<0.001) were independently associated with a reduced OS. Furthermore, ferritin level> 1000 ug/L (OR 3.41; p=0.006) and the atypical erythroid localization (OR 2.65; p=0.004) were significantly associated with the presence of MF ≥1. Our results highlight the presence of any grade of myelofibrosis as an independent adverse prognostic factor for survival in MDS, associated with higher ferritin level and abnormal erythroid localization in the BM.
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