[Myelodysplastic syndromes. Clinico-pathologic analysis of 54 cases].
For myelodysplastic syndromes (MDS) many scoring systems were developed to improve the prognostic stratification of patients.
We enrolled 54 primary MDS patients, having an advanced median age of 78.5 years, that discouraged the choice of aggressive treatments. Then, we employed only the Bournemouth score (without cytogenetic analysis), with the aim to identify the best predictor of death and of AML development.


RESULTS
Both for overall and leukemia-free analysis, shorter survival and faster development of AML were found in MDS patients with severe peripheral cytopenia, RAEB-T, major proportion of bone marrow blasts (over 20%) and with the higher Bournemouth score (i.e. 3-4). The multivariate analysis by the Cox's regression model showed that a high percentage of bone marrow blasts presented the best statistical significance.


CONCLUSIONS
In our survey we confirmed the value of Bournemouth score in identifying those MDS patients presenting a greater risk of death and AML development. Moreover, a high percentage of bone marrow blasts rose as the best predictor of death and leukemic evolution. The kariotypic analysis, with a stronger prognostic power but also complex and expensive, was not performed in our elderly MDS patients, who were unable to tolerate aggressive treatments.
Luraschi
A
A
Divisione di Medicina, Ospedale di Omegna, Omegna.
Buscaglia
P
P
Fedeli
P
P
Montanara
S
S
Uccelli
E
E
Antonietti
M P
MP
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate