Myelodysplastic Syndromes in Pakistani Population-Analysis of 52 Cases and their Outcome on Best Available Treatment Options

The Myelodysplastic syndromes (MDS) are clonally evolved bone marrow disorders leading to the bone marrow failure, peripheral cytopenia and a propensity for progression to acute myeloid leukemia (AML). To observe the trend and outcome of MDS in Pakistani population, a retrospective data analysis was carried out in National Institute of Blood Diseases & Bone Marrow Transplantation, from January 2010 to December 2014. Fifty-two MDS or MDS/MPN cases were analyzed out of which39 (75%) were males. Median age at the time of diagnosis was 60 years. Secondary/t-MDS was observed in 2 (3.8%) cases while others were de-novo MDS. Low intensity treatment was offered to 16 (30.7%) cases out of which 5 (31.25%) cases responded to treatment. Full HLA matched related donor allogenic HSCT was unsuccessfully attempted in 2 (3.8 %) cases. At the time of analysis only 19cases were alive after a median follow up 10 months (range 2 months to 48 months). Median progression free survival was 1.9 months for very high risk, 6 Months for high risk, 12.8 months for intermediate risk and 39 Months for very low and low risk while median overall survival was 3 months for very high risk, 8.5 months for high risk and 18.7 months for intermediate risk. All patients were alive in very low and low risk category when study was concluded.