title: The degree of neutropenia has a prognostic impact in low risk myelodysplastic syndrome.
abstract: The severity of neutropenia in myelodysplastic syndrome (MDS) has not been completely studied. We analyzed the prognostic significance of severe neutropenia (neutrophils count <0.5×10(9)/L) at diagnosis in 1109 patients with de novo MDS and low/intermediate-1 IPSS included in the Spanish MDS Registry. Severe neutropenia was present at diagnosis in 48 of 1109 (4%). Patients with severe neutropenia were most strongly represented within the groups of refractory cytopenia with multilineage dysplasia (40%) and refractory anemia with excess of blast type 1 (29%). Severe neutropenia had negative effects on the low/intermediate-1 risk group. A significant difference in overall survival was observed between patients with severe neutropenia (28 months) and patients with a neutrophil count higher than 0.5×10(9)/L (66 months) (p<0.0001). Also, severe neutropenia predicted a significantly reduced on leukemia-free survival (p<0.0001). In the multivariate analysis, severe neutropenia retained its independent prognostic influence on overall survival [HR: 2.19, 95% CI (1.41-3.10), p<0.0001] and leukemia free survival [HR: 3.51, 95% CI (1.97-6.26), p<0.0001]. The degree of neutropenia should be considered as additional prognostic factor in low/intermediate-1 IPSS MDS.
authors: Hospital Universitario de Salamanca, Paseo de San Vicente, Salamanca, Spain.
authors: I
authors: I
authors: Cordoba
authors: J R
authors: JR
authors: Gonzalez-Porras
authors: E
authors: E
authors: Such
authors: B
authors: B
authors: Nomdedeu
authors: E
authors: E
authors: Luño
authors: R
authors: R
authors: de Paz
authors: F
authors: F
authors: Carbonell
authors: T
authors: T
authors: Vallespi
authors: M
authors: M
authors: Ardanaz
authors: F
authors: F
authors: Ramos
authors: V
authors: V
authors: Marco
authors: S
authors: S
authors: Bonanad
authors: M
authors: M
authors: Sanchez-Barba
authors: D
authors: D
authors: Costa
authors: T
authors: T
authors: Bernal
authors: G F
authors: GF
authors: Sanz
authors: M C
authors: MC
authors: Cañizo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000401:mortality; D009367:Neoplasm Staging; D009503:Neutropenia / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult