Clinical features of prognostic significance in myelodysplastic patients with normal karyotype at high risk of transformation.
The International Prognostic Scoring System (IPSS) for myelodysplastic syndromes (MDS) has defined patients with a normal karyotype as a good risk cytogenetic subgroup, but nevertheless a fraction of these patients has a poor outcome similar to that of high risk patients. We retrospectively analysed our series of myelodysplastic patients with normal karyotype observed in a period of 11 years, with the aim of identifying clinical features of possible prognostic significance within this subgroup of patients. Multivariate analysis showed that among clinical scoring systems, the Bournemouth score appears the best prognostic indicator for risk of leukemic transformation, and platelet count <100 x 10(9)/l(-1), presence of haemorrhagic symptoms at time of diagnosis and morphologic FAB classification are the main prognostic factors for prediction of survival. In the absence of genetic abnormalities as detected by conventional cytogenetics or even the more sensitive molecular techniques in MDS, clinical variables could be of help in identifying patients with different prognosis, suitable for risk adapted therapeutic strategies.
Breccia
Massimo
M
Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Via Benevento 6, 00161 Rome, Italy. breccia@bce.uniroma1.it
Mancini
Marco
M
Nanni
Mauro
M
D'Elia
Gianna Maria
GM
Carmosino
Ida
I
Latagliata
Roberto
R
Sarlo
Chiara
C
Mandelli
Franco
F
Alimena
Giuliana
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D007621:Karyotyping; D007938:Leukemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment