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Life expectancy in primary myelodysplastic syndromes: A prognostic score based upon histopathology from bone marrow biopsies of 569 patients
- Source :
- European Journal of Haematology. 53:280-287
- Publication Year :
- 2009
- Publisher :
- Wiley, 2009.
-
Abstract
- The retrospective evaluation of bone marrow biopsies of 569 patients with primary myelodysplastic syndrome--pMDS--revealed 256 refractory anemias--RA--, 52 refractory anemias with ringed sideroblasts--RARS--, 133 refractory anemias with excess of blasts--RAEB--, 52 refractory anemias with excess of blasts in transformation--RAEB-t--, and 53 chronic myelo-monocytic leukemias--CMMOL--according to FAB-criteria, 23 patients were not otherwise specified (myelodysplastic syndrome: not otherwise specified--MDS.NOS--). RARS-patients had the best prognosis (median survival 41.9 months, incidence of leukemia 3.8%), followed by RA-patients (26.5 months, 16.4%), MDS.NOS-patients (22.4 months, 21.7%), CMMOL-patients (12.5 months, 49.1%). RAEB- and RAEB-t-patients had the worst prognosis (median survival time 8.5 and 4.6 months, incidence of leukemia 42.1% and 57.7%, respectively). But the survival times showed a considerable range in each FAB-subgroup with 0-154 months in RA or 0-52 months in CMMOL. To forecast life expectancy more precisely, a scoring system was developed using nine histopathological parameters, among which the three most important ones were determined: quantity of myeloblasts, myelofibrosis and ALIP's. The scoring system allows a determination of three risk groups with significantly different survival times. It is valid also for patients without increase of myeloblasts (< 5% myeloblasts in the bone marrow) and identifies high-risk MDS patients in this group. By this proposed scoring system, a prognostic approval in primary MDS can be achieved applying histopathology without regarding further methods herewith presenting a system which could be considered independently from hematologic, cytological or laboratory data.
- Subjects :
- Adult
Male
medicine.medical_specialty
Biopsy
Gastroenterology
Life Expectancy
Refractory
Bone Marrow
Risk Factors
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Erythropoiesis
Mast Cells
Myelofibrosis
Survival analysis
Aged
Aged, 80 and over
business.industry
Myelodysplastic syndromes
Incidence (epidemiology)
Not Otherwise Specified
Hematology
General Medicine
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Surgery
Leukemia
medicine.anatomical_structure
Myelodysplastic Syndromes
Multivariate Analysis
Female
Bone marrow
business
Subjects
Details
- ISSN :
- 16000609 and 09024441
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- European Journal of Haematology
- Accession number :
- edsair.doi.dedup.....c39d9014d0ece2a4b4f38083042b4907