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Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS).
- Source :
-
Haematologica [Haematologica] 2011 Oct; Vol. 96 (10), pp. 1433-40. Date of Electronic Publication: 2011 Jun 09. - Publication Year :
- 2011
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Abstract
- Background: Anemia is an established negative prognostic factor in myelodysplastic syndromes but the relationship between its degree and clinical outcome is poorly defined. We, therefore, studied the relationship between severity of anemia and outcome in myelodysplastic syndrome patients.<br />Design and Methods: We studied 840 consecutive patients diagnosed with myelodysplastic syndromes at the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, and 504 patients seen at the Heinrich-Heine-University Hospital, Düsseldorf, Germany. Hemoglobin levels were monitored longitudinally and analyzed by means of time-dependent Cox's proportional hazards regression models.<br />Results: Hemoglobin levels lower than 9 g/dL in males (HR 5.56, P=0.018) and 8 g/dL in females (HR=5.35, P=0.026) were independently related to reduced overall survival, higher risk of non-leukemic death and cardiac death (P<0.001). Severe anemia, defined as hemoglobin below these thresholds, was found to be as effective as transfusion-dependency in the prognostic assessment. After integrating this definition of severe anemia into the WHO classification-based Prognostic Scoring System, time-dependent regression and landmark analyses showed that the refined model was able to identify risk groups with different survivals at any time during follow up.<br />Conclusions: Accounting for severity of anemia through the WHO classification-based Prognostic Scoring System provides an objective criterion for prognostic assessment and implementation of risk-adapted treatment strategies in myelodysplastic syndrome patients.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Female
Heart Diseases complications
Heart Diseases mortality
Humans
Iron Overload etiology
Kaplan-Meier Estimate
Male
Middle Aged
Myelodysplastic Syndromes diagnosis
Prognosis
Transfusion Reaction
World Health Organization
Young Adult
Anemia complications
Myelodysplastic Syndromes complications
Myelodysplastic Syndromes mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 96
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 21659359
- Full Text :
- https://doi.org/10.3324/haematol.2011.044602