[The prognostic value of a modified WPSS based on routine laboratory parameters in patients with myelodysplastic syndromes: a preliminary result].
OBJECTIVE
To investigate the prognostic value of a modified WPSS based on routine laboratory parameters in Chinese patients with myelodysplastic syndromes (MDS).


METHODS
One hundred and sixty four adult MDS patients were retrospectively analyzed.


RESULTS
The median follow-up time was 19 (1-138) months and the median survival (MS) was 36 months. 2-year prospective survival (PS) was 60% and 5-year PS was 42%. In patients with very low-risk, low-risk, intermediate-risk, high-risk and very high-risk stratified by WPSS, 2-year PS was 100%, 96%, 81%, 38% and 14%, and 5-year PS was 100%, 83%, 54%, 20% and 0, respectively (P<0.01). Among parameters of laboratory routine examination, elevated mean cell volume (MCV), mean cell hemoglobin (MCH), neutrophil alkaline phosphatase (N-ALP) index and nucleated RBC PAS negative were good prognostic factors, while reduced Hb, BPC and bone marrow elevated blasts, dysplasia more than 1 lineage, and lymphocyte-like micromegakaryocyte (MEGly) as well as elevated serum LDH were poor prognostic factors in uni-variable analysis. Among them, MCV, MEGly and blast had independent prognostic significance in multi-variable analysis (P = 0.011, 0.013 and 0.016, respectively). WPSS was modified by omitting chromosomal karyotype and transfusion dependence and adding MCV and MEGly. In patients with low-risk, intermediate-risk and high-risk stratified by modified WPSS, 2-year PS was 94%, 68% and 49%, respectively; and 5-year PS was 86%, 53% and 14%, respectively (P<0.01).


CONCLUSIONS
The modified WPSS worked well for prognostic prediction in Chinese patients with MDS.
Institute of Hematology and Blood Diseases Hospital, CAMS, State Key Laboratory of Experimental Hematology, Tianjin 300020, China.
Lin
L
Li
Ling
L
Nie
Ming-hua
MH
Yu
Yang
Y
Yu
Liang
L
Liu
Tie-jun
TJ
Qin
Ze-feng
ZF
Xu
Yue
Y
Zhang
Zhi-jian
ZJ
Xiao
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult